Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions
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Background: Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.
Abstract
Background: Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.
참고문헌 (16)
- 정규원, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2011", Cancer Research and Treatment, 46(2), pp.109~123 (2014), 대한암학회
- Matsumoto K, "Effect of pancreatic juice cytology and", or endoscopic ultrasound-guided fine-needle aspiration biopsy for pancreatic tumor, 2014, pp.29, 223~227
- Bluen BE, "Accuracy and quality assessment of EUS-FNA : a single-center large cohort of biopsies", Diagn Ther Endosc, 2012, pp.139563~ (2012)
- Hewitt MJ, "EUS-guided FNA for diagnosis of solid pancreatic neoplasms : a meta-analysis", Gastrointest Endosc, 75, pp.319~331 (2012)
- Yoshinaga S, "Role of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)for diagnosis of solid pancreatic masses", Dig Endosc, 23(Suppl 1), pp.29~33 (2011)
- 김태현, "Histology Combined with Cytology by Endoscopic Ultrasound-Guided Fine Needle Aspiration for the Diagnosis of Solid Pancreatic Mass and Intra- Abdominal Lymphadenopathy", Gut and Liver, 7(5), pp.605~610 (2013), 거트앤리버 발행위원회
- Matsuyama M, "Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis", World J Gastroenterol, 19, pp.2368~2373 (2013)
- Fisher L, "Endoscopic ultrasound guided fine needle aspiration of solid pancreatic lesions : performance and outcomes", J Gastroenterol Hepatol, 24, pp.90~96 (2009)
- Ardengh JC, "Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration", World J Gastroenterol, 13, pp.3112~3116 (2007)
- Varadarajulu S, "Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis", Gastrointest Endosc, 62, pp.728~736 (2005)
- Mitsuhashi T, "Endoscopic ultrasound-guided fine needle aspiration of the pancreas: cytomorphological evaluation with emphasis on adequacy assessment, diagnostic criteria and contamination from the gastrointestinal tract", Cytopathology, 17, pp.34~41 (2006)
- Erickson RA, "Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies", Gastrointest Endosc, 51, pp.184~190 (2000)
- Kawamoto S, "Lymphoplasmacytic sclerosing pancreatitis(autoimmune pancreatitis) : evaluation with multidetector CT", Radiographics, 28, pp.157~170 (2008)
- Abraham SC, "Eosinophilic pancreatitis and increased eosinophils in the pancreas", Am J Surg Pathol, 27, pp.334~342 (2003)
- Moriya T, "Pancreatic schwannoma : Case report and an updated 30-year review of the literature yielding 47 cases", World J Gastroenterol, 18, pp.1538~1544 (2012)
- Navina S, "Adequacy assessment of endoscopic ultrasound-guided, fine-needle aspirations of pancreatic masses for theranostic studies: optimization of current practices is warranted", Arch Pathol Lab Med, 138, pp.923~928 (2014)