Efficacy of endoscopic ultrasound guided fine needle aspiration in patients with solid pancreatic neoplasms

Abstract

Background/Aim:Endosonography is a distinct method for evaluating the structural lesions of the gastrointestinal (GI) tract, particularly the pancreatobilliary region. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesion through providing fine needle aspiration. This study aims at evaluating the results and efficacy of endoscopic ultrasound fine needle aspiration (EUS-FNA) in patients with pancreatic solid mass.Patients and Methods:The present study is an observational, prospective case series nature, evaluated patients with pancreatic solid mass referred to Imam Khomeini educational hospital in Tehran for a duration of one year since November 2010. In order to determine the false negative cases, the patients were followed-up from 6 to 12 months.Results:EUS-FNA was conducted on all 53 patients without any complication. The majority of patients included in the study were males (68%) and 81% of patients had a mass in the head of pancreas. The result of cytopathology revealed 36 adenocarcinomas (68%), 7 other malignancies (13%), benign lesions (6%) and 7 non-diagnostic cases (13%). The frequency of non-diagnostic results was significantly high in masses smaller than 3 cm (6 vs. 1, P < 0.002). Patients with non-diagnostic result were younger than those with malignant cytopathology (52 ± 7.5 vs. 66 ± 7.5 years, P < 0.001).. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of this procedure concerning Adenocarcinoma were 88%, 100%, 100%, 70% and 90%, respectively.Conclusion:EUS – FNA is an effective and safe procedure in histopathologic diagnosis of pancreatic tumors. This procedure is useful in all pancreatic mass cases including resectable and non-resectable ones.

Impact of inconclusive endoscopic ultrasound‐guided fine‐needle aspiration results in the management and outcome of patients with solid pancreatic masses

“…The role of EUS‐FNA is debated in potentially resectable pancreatic tumors . It is, however, considered useful to help differentiate benign neoplasms or lesions that mimic pancreatic cancer and to assist with surgical planning.…”

“…The role of EUS-FNA is debated in potentially resectable pancreatic tumors. [16][17][18][19] It is, however, considered useful to help differentiate benign neoplasms or lesions that mimic pancreatic cancer and to assist with surgical planning. In a large prospective study of 103 consecutive patients with resectable pancreatic lesions, 20 three patients with solid pancreatic masses highly suspicious for malignancy underwent surgical resection despite a negative EUS-FNA.…”

Endoscopic ultrasound-guided fine needle aspiration: From the past to the future

“…Thus, in most cases it is possible to avoid unnecessary surgical interventions in advanced pancreatic cancer, and EUS is considered the preferred method for loco-regional staging of pancreatic cancer. A medical literature review to evaluate the role of EUS-FNA for diagnosis of solid pancreatic masses showed a 78%-95% sensitivity, 75%-100% specificity, and 78%-95% accuracy,17222324252627282930313233 confirming that EUS-FNA is an effective and safe method to obtain a cytological diagnosis of pancreatic tumors 30…”

Resectability of the pancreatic adenocarcinoma: A study from Iran

“…Other advantages of EUS include accurate assessment of peripancreatic nodal disease and allowance of tumor biopsy by fine-needle aspiration (FNA). [ 10 11 ] However ductal adenocarcinomas can elicit a strong desmoplastic reaction in some cases that is responsible for hard consistency of the tumor and sampling error in EUS-FNA.…”