4700 Intraductal tissue sampling in mucin-secreting and cystic tumors of the pancreas - a multicenter series.

Abstract

INTRODUCTION: Optimal management of patients with mucin secreting and cystic pancreatic neoplasms is dependent on the accurate detection of malignancy. AIM: This large multicenter series reports the cancer detection sensitivity of endoscopic pancreatic intraductal tissue and juice sampling techniques. METHODS: A series of 206 mucin-secreting or cystic tumors of the pancreas have been recorded by the Midwest Pancreaticobiliary Group. Of these, 92 patients underwent ERCP with tissue and/or juice sampling and have surgical pathology to confirm the final diagnosis. The sampling technique was at the discretion of the endoscopist. Specimens were reported as benign or malignant and for the purposes of this analysis, all grades of cellular atypia were classified as benign. RESULTS: See table. All 38 benign lesions had at least 1 benign and no malignant tissue specimens. Twelve of the 54 (22%) malignant lesions had at least one positive specimen. SUMMARY: The sensitivity of multiple tissue sampling techniques in detecting malignant mucin secreting or cystic pancreatic tumors was only 22%. All benign pancreatic lesions sampled had benign tissue specimens. CONCLUSIONS: Improved endoscopic tissue sampling techniques are required in order to classify mucin secreting and cystic lesions of the pancreas as either benign or malignant. **And Members of the Midwest Pancreatobiliary Group. INTRODUCTION: Optimal management of patients with mucin secreting and cystic pancreatic neoplasms is dependent on the accurate detection of malignancy. AIM: This large multicenter series reports the cancer detection sensitivity of endoscopic pancreatic intraductal tissue and juice sampling techniques. METHODS: A series of 206 mucin-secreting or cystic tumors of the pancreas have been recorded by the Midwest Pancreaticobiliary Group. Of these, 92 patients underwent ERCP with tissue and/or juice sampling and have surgical pathology to confirm the final diagnosis. The sampling technique was at the discretion of the endoscopist. Specimens were reported as benign or malignant and for the purposes of this analysis, all grades of cellular atypia were classified as benign. RESULTS: See table. All 38 benign lesions had at least 1 benign and no malignant tissue specimens. Twelve of the 54 (22%) malignant lesions had at least one positive specimen. SUMMARY: The sensitivity of multiple tissue sampling techniques in detecting malignant mucin secreting or cystic pancreatic tumors was only 22%. All benign pancreatic lesions sampled had benign tissue specimens. CONCLUSIONS: Improved endoscopic tissue sampling techniques are required in order to classify mucin secreting and cystic lesions of the pancreas as either benign or malignant. **And Members of the Midwest Pancreatobiliary Group.