Usefulness of endoscopic ultrasound-guided fine-needle aspiration biopsy for the diagnosis of pancreatic cancer

Abstract

EUS-FNAB is an efficient and safe method for the histologic diagnosis of pancreatic cancer. It should be considered as one of the indispensable modalities for the histological diagnosis of pancreatic cancer in Japan, as it is in Western countries.

Ultrasound-guided percutaneous pancreatic tumor biopsy in pancreatic cancer: a comparison with metastatic liver tumor biopsy, including sensitivity, specificity, and complications

“…The reported rate of postbiopsy pancreatitis ranges from 0% to 1.7%. 4,5,8,[11][12][13] In patients with unresectable pancreatic cancer, the tumors are large and usually located just under the surface of the pancreas, allowing percutaneous puncture of the tumor without penetrating the normal pancreatic tissue. This is probably why biopsy-related pancreatitis is unlikely to develop, as Smith 7 has suggested.…”

Preoperative tissue diagnosis for tumours of the pancreas

“…The remaining studies were based on predominantly retrospective analyses of prospectively collected data or on the retrospective identification of biopsy samples or of patients who underwent biopsy. In several articles inadequate biopsy specimens were excluded from calculations of sensitivity, specificity, negative predictive value and accuracy 38,56,60,67,75,82 . Volmar et al 36 compared *ultrasonography-guided fine-needle aspiration (FNA) and † computed tomography-guided FNA.…”

Complications of endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) for pancreatic lesions

“…Thus EUS-FNAB shows high diagnostic accuracy, but it has not been widely accepted in Japan because of technical difficulties, the cost of the equipment, and the complications. Ryozawa et al 8 pointed out these same three reasons to explain why EUS-FNAB is not widely used in Japan. They also stressed in their article that physicians in Japan are concerned about tissue samplings by EUS-FNAB because of the risk of procedural complications, including the peritoneal dissemination of tumor cells.…”

“…6 The sensitivity, and specificity of EUS-FNAB for pancreatic neoplasms in different series are 64%-85%, and 90%-100%, respectively. 7 In this issue, Ryozawa et al 8 reported that the diagnostic accuracy, sensitivity, and specificity of EUS-FNAB for pancreatic neoplasm are 89.4%, 82.1%, and 100%, respectively. Their results concur with findings reported so far.…”

“…11 Ryozawa et al reported no complications related to EUS-FNAB. 8 We have experienced EUS-FNAB-related complications in 0.79% (6/760) of cases. 12 They involved three peritumoral hematomas (two asymptomatic and one symptomatic), one massive bleeding in a case of gastric submucosal tumor using a trucut needle, one acute portal vein thrombosis in a case of advanced pancreatic cancer, and one rupture of a pancreatic pseudoaneurysm followed by massive gastrointestinal bleeding in a case of advanced pancreatic cancer.…”