Clinical analysis of 250 cases of ultrasound-guided percutaneous fine needle aspiration of pancreatic mass

Abstract

Objective To assess the accuracy and safety of cytopathological diagnosis of ultrasound guided fine needle aspirated(US-FNA)pancreatic masses.Methods From January 2008 to February 2013,250 pancreatic mass cases underwent US-FNA and with cytopathological diagnosis were retrospectively analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calculated.The stratified analysis of accuracy was compared by Pearson x2 test.Results Among 250 patients,the results of US-FNA cytological analysis indicated that cancer cells were found in 221 cases; atypical cells in two cases; nine cases were suspicious cancer and all of them were confirmed malignant in the end.Among the 18 patients with negative diagnostic results (epithelial cell proliferated in two cases,tissue liquefaction necrosis in two cases,inflammatory cells in one case and 13 cases without malignant cells) 12 cases were finally proved malignant and six cases were benign (three cases of pancreatic benign tumor,one case of pancreatic pseudocyst,one case of pancreatic tuberculosis and one case of pancreatitis).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of US-FNA in pathological diagnosis were 90.57％,100.00％,100.00％,20.68％ and 90.80％,respectively.The results of stratified analysis indicated that the diagnostic accuracy of US-FNA in mass with diameter ≥3 cm was significantly higher than that with diameter ＜3 cm,but the difference wasn't statistically significant (P＞0.05).Among 250 patients,45 patients had slight abdominal pain and all were self healing.No other complications were found.All patients were followed up until death or at least six months and no peritoneal spread through needle tract seeding was detected after long time follow-up.Conclusions The US-FNA in pancreatic mass diagnosis has a high accuracy and a good safety with low cost and easy operation.It is a good choice for the pathological diagnosis of unresectable pancreatic lesion. Key words: Ultrasonography; Biopsy, fine-needle; Pancreatic neoplasm