Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions

Pancreas;Endoscopic ultrasound-guided fine needle aspiration cytology;EUS-FNAC;Accuracy;Diagnosis;Evaluation;Cytopathology;610

의과대학 의학과 ;

University:서울대학교 대학원

关键词: Pancreas;    Endoscopic ultrasound-guided fine needle aspiration cytology;    EUS-FNAC;    Accuracy;    Diagnosis;    Evaluation;    Cytopathology;    610;   

Others  :  http://s-space.snu.ac.kr/bitstream/10371/142326/1/000000150339.pdf

美国|英语

来源: Seoul National University Open Repository

【 摘 要 】

Background: Endoscopic ultrasound–guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and histologic diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of pancreas.Methods: A retrospective review of 191 cases of pancreatic lesion initially diagnosed by EUS-FNAC with subsequent histologic diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital, was performed. Cytologic and histologic diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both histologic and cytology specimens were statistically analyzed to determine correlations with diagnoses.Results: In comparison to histologic 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%. Diagnostic accuracy according to specific histological diagnosis was 79.1% in malignant neoplasm (76.5%, 91.7%, 62.5%, 100% in ductal adenocarcinoma, neuroendocrine neoplasm, intraductal papillary mucinous neoplasm, and the other malignant tumor, respectively), and 76.3% in benign lesion.Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. A low negative predictive value and numerous discrepant cases were due to insufficient yield of tissue or targeting-error of the lesion by aspiration. Overcoming such limitations of EUS-FNAC will make it useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.