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| Comparison of cytological and histological preparations in the diagnosis of pancreatic malignancies using endoscopic ultrasound-guided fine needle aspiration |
| Dong Kee Jang, Sang Hyub Lee, Jun Kyu Lee, Woo Hyun Paik, Kwang Hyun Chung, Ban Seok Lee, Jun Hyuk Son, Jae Woo Lee, Ji Kon Ryu, Yong-Tae Kim and Kyoung-Bun Lee |
Seoul, Korea
Author Affiliations: Department of Internal Medicine, Dongguk University Ilsan Medical Center, Goyang-si, Gyeonggi-do, Korea (Jang DK and Lee JK); Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea (Jang DK, Lee SH, Paik WH, Chung KH, Lee BS, Lee JW, Ryu JK and Kim YT); Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Korea (Son JH); Department of Pathology, Seoul National University College of Medicine, Seoul, Korea (Lee KB)
Corresponding Author: Sang Hyub Lee, MD, PhD, Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea (Tel: +82-2-2072-4892; Fax: +82-2-762-9662; Email: gidoctor@snuh.org) |
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Abstract BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has become a crucial diagnostic technique for pancreatic malignancies. The specimen obtained by EUS-FNA can be prepared for either cytological or histological examinations. This study was to compare diagnostic performance of cytological and histological preparations using EUS-FNA in the same lesions when pancreatic malignancies were suspected.
METHODS: One hundred and eighteen patients who underwent EUS-FNA for suspected pancreatic malignancies were consecutively enrolled. All procedures were conducted by a single echoendoscopist under the same conditions. Four adequate preparations were obtained by 22-gauge needles with 20 to-and-fro movements for each pass. The 4 preparations included 2 cytological and 2 histological specimens. The pathologic reviews of all specimens were conducted independently by a single experienced cytopathologist. Sensitivity, specificity, and accuracy of the 2 preparations were compared.
RESULTS: The enrolled patients consisted of 62 males (52.5%), with the mean age of 64.6±10.5 years. Surgery was performed in 23 (19.5%) patients. One hundred and sixteen (98.3%) lesions were classified as malignant, while 2 (1.7%) were benign. Sensitivity of cytology and histology were 87.9% and 81.9%, respectively, with no significant difference (P=0.190). Accuracy was also not significantly different. Cytological preparation was more sensitive when the size of lesion was <3 cm (86.7% vs 68.9%, P=0.033).
CONCLUSIONS: Our results suggested that the diagnostic performances of cytological and histological preparations are not significantly different for the diagnosis of pancreatic malignancies. However, cytological preparation might be more sensitive for pancreatic lesions <3 cm.
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2017, Vol. 16 
