P-043 - Scope position is a determining factor for diagnostic performance of EUS-FNA for mass lesions in the pancreas head and uncinate process

Abstract

Introduction: The aim of this study was to explore the clinical and endoscopic factors that determine the diagnostic performance of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for mass lesions in the pancreas head and uncinate process. Methods: Seventy-eight consecutive patients with suspected mass lesions in the pancreas head and uncinate process by contrast-enhanced multidetector-row computed tomography (MDCT) and/or magnetic resonance imaging (MRI) who underwent EUS-FNA for cytologic and/or histologic confirmation at our institution between June 2012 and April 2017 were enrolled in the current study. Results: The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EUS-FNA for mass lesion(s) in the pancreas head and uncinate process in our series were 61/69 (88.4%), 9/9 (100.0%), 61/61 (100.0%), 9/17 (52.9%), and 70/78 (89.7%), respectively. The clinical and endoscopic determining factors for diagnostic performance of EUS-FNA were echoendoscope position during needle puncture (long vs. short scope position), and the distance from echoendoscope to the mass lesion (<1 cm vs ≥1 cm) in univariate analyses. In the multivariate logistic regression analysis, only the echoendoscope position during needle puncture was an independent and significant determining factor for diagnostic performance of EUS-FNA for mass lesion(s) in the pancreas head and uncinate process. Conclusion: The echoendoscope position during needle puncture is a determining factor for the diagnostic performance of EUS-FNA for mass lesions in the pancreas head and uncinate process.