Endoscopic ultrasonography-guided fine-needle aspiration in diagnosis of pancreatic cancer

Abstract

Objective To evaluate the diagnostic value of endoscopic uhrasonography-guided fineneedle aspiration （EUS-FNA） for pancreatic occupying lesion, especially pancreatic cancer. Methods From year of 2005, 37 patients with suspected pancreatic cancer by means of ultrasound, CT or MRI received EUS-FNA. Amylase and tumor markers （CEA, CA19-9 and CA125） in cyst fluid were analyzed if applicable. The patients were followed up till July 2008, and the results of EUS-FNA were compared with those confirmed during the follow-up. Results The EUS-FNA yielded diagnosis of 16 cases of pancreatic ductal adenocarcinoma, 1 metastatic renal cancer, 5 suspicious malignancy, 6 atypia, 6 normal pancreatic tissue, and 3 normal non-pancreatic tissue. During the follow-up, 25 cases of pancreatic cancer and 10 benign lesions, including 4 chronic pancreatitis, 4 cyst-adenoma and 2 pseudocyst, were confirmed, and the other 2 cases still remained un-determined. The sensitivity, specificity, positive predictive value and negative predictive value of EUS-FNA were 80. 0% （95% CI： 59. 0-93.0） , 100. 0% （95% CI： 60. 0-100. 0） , 100. 0% （95% CI： 80. 0-100. 0）, and 55.6% （95% CI： 27.0-79. 0）, respectively. No severe procedurerelated complication was observed. Conclusion EUS-FNA is a safe and effective modality for diagnosis of pancreatic occupying lesions, especially panereatic cancer. Key words: Endoscopic ultrasonography ; Aspiration biopsy, fine-needle ; Pancreatic cancer