Endoscopy 2019; 51(04): S44
DOI: 10.1055/s-0039-1681299
ESGE Days 2019 oral presentations
Friday, April 5, 2019 11:00 – 13:00: EUS diagnosis pancreas Club D
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC ULTRASOUND-GUIDED FINE-NEEDLE ASPIRATION FOR PANCREATIC SOLID LESIONS: CYTOLOGY, HISTOLOGY OR BOTH?

M João
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
L Elvas
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
D Brito
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
S Alves
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
M Areia
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
F Taveira
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
S Saraiva
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
,
AT Cadime
1   Gastroenterology, Instituto Português de Oncologia de Coimbra Francisco Gentil, Coimbra, Portugal
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the gold standard procedure for obtaining pathological diagnosis of pancreatic solid lesions. The specimen obtained by EUS-FNA can be prepared for either cytological or histological (cellblock) examinations. The aim of our study was to compare diagnostic accuracy of cytology, cellblock and both, in the absence of on-site pathologist.

Methods:

We performed a retrospective study including all patients submitted to EUS-FNA of pancreatic solid lesions at an oncology centre between January 2006 and October 2018. Data were collected from electronic medical reports. Final diagnosis was based on surgical pathology or clinical follow-up. Patients with either cytology or cellblock specimen considered 'insufficient for diagnosis' were excluded.

Results:

A total of 129 patients were included (median age: 67 ± 17 years, male:70 (54.3%)). The median size of lesions was 32.0 ± 14.5 mm; a 22G needle was used in 91.5% and median number of passages was 3 ± 1. Most lesions were adenocarcinoma (58 (45%)) and neuroendocrine tumours (23 (17.8%)) and were mostly located in the pancreatic head (54 (41.9%)) and body (32 (24.8%)). Three (2.3%) procedures were complicated with self-limited bleeding. Sensitivity, specificity, positive and negative predictive values and accuracy, for the diagnosis of malignancy were 92.3%, 82.4%, 97.0%, 63.6% and 90.9% for cytology; 96.9%, 75.0%, 97.9%, 66.7% and 95.2% for cellblock and 98.2%, 76.5%, 96.5%, 86.7% and 95.3% for both, respectively. All values obtained were statistically significant. No differences were found in diagnostic accuracy between different needle sizes (p = 0.235) or number of passages (p = 0.465).

Conclusions:

Combined cytological and histological analysis for diagnosing pancreatic solid lesions may increase the diagnostic yield of conventional EUS-FNA without on-site cytology. These results are similar to rates reported in the literature.