Diagnostic Efficacy of Cell Block Immunohistochemistry, Smear Cytology, and Liquid-Based Cytology in Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Pancreatic Lesions: A Single-Institution Experience

Abstract

BackgroundThe diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB) immunohistochemistry, smear cytology (SC), and liquid-based cytology (LBC) in patients with pancreatic lesions without consulting an on-site cytopathologist.MethodsThis study prospectively enrolled 72 patients with pancreatic lesions. The EUS-FNA specimens were examined by SC, LBC, and CB immunohistochemistry. The diagnostic efficacy of the 3 methods was then compared. Patients’ final diagnosis was confirmed by surgical resection specimens, diagnostic imaging, and clinical follow-up.ResultsOur results included 60 malignant and 12 benign pancreatic lesions. The diagnostic sensitivity (90%), negative predictive value (66.7%), and accuracy (91.7%) of CB immunohistochemistry were significantly higher than those of SC (70.0%, 30.0%, and 75.0%, respectively) and LBC (73.3%, 31.6%, and 77.8%, respectively) (all P<0.05). The combination of CB and SC, or CB and LBC, did not significantly increase the efficacy compared to CB immunohistochemistry alone.ConclusionOur findings suggest that in the absence of an on-site cytopathologist, CB immunohistochemistry on EUS-FNA specimens offers a higher diagnostic efficacy in patients with pancreatic lesions than does SC and LBC.

Endoscopic ultrasound guided fine‐needle aspiration: What variables influence diagnostic yield?

“…Liquid‐based cytology (LBC) might be one of the possibilities to overcome the need for on‐site evaluation as demonstrated in a few recent studies . However, study by Qin et al revealed that the CB immunohistochemistry on EUS–FNA samples of pancreatic lesions provided higher diagnostic efficiency than the liquid based cytology and smear cytology …”

Thinprep® test versus conventional smear for the detection of pancreatic neoplasms after percutaneous ultrasound-guided fine-needle aspiration biopsy

“…The rst two studies used BD SurePath™ (BD Diagnostics, Burlington, N.C., USA), a different system from ThinPrep® in cell collection and specimen preparation. In addition, both the prospective study from Shan-yu Qin et al [23] and Jund Won Chun reported the diagnostic e cacy of TCT to be relatively higher than that of CS, though there was no signi cant difference. In 2005, Momin T. Siddiqui et al [24] revealed that, with the help of Endoscopic retrograde cholangio-pancreatography (ERCP), TCT was more sensitive in detection of malignancy compared to CS (with ROSE).…”

Fine-Needle Aspiration with Immunohistochemistry Using a Modified Scrape Cell Block Technique for the Diagnosis of Thyroid and Parathyroid Nodules

“…The cellblock technique for IHC has been used for a variety of solid tumors, such as those of the lung, pancreas, and breast, as well as lymphoma [19,20,21]. Yung et al [22] reported on a ‘tissue coagulum clot' cell block technique.…”