Yield of endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for solid pancreatic neoplasms |
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Authors: | Mohamed Malak Daisuke Masuda Takeshi Ogura Akira Imoto Usama M. Abdelaal Eman A. Sabet |
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Affiliation: | 1. Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Osaka, Japan and;2. Department of Internal Medicine, Sohag Faculty of Medicine, Sohag University, Nasser city, Sohag, Egypt;3. Second Department of Internal Medicine, Osaka Medical College, 2-7, Daigakumachi, Osaka, Japan and;4. Department of Internal Medicine, Sohag Faculty of Medicine, Sohag University, Nasser city, Sohag, Egypt |
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Abstract: | Objective: Both endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) cytology may provide tissue diagnoses in solid pancreatic neoplasms. However, there are scant data comparing these two methods. This study aims at retrospectively comparing EUS-FNA and ERCP tissue sampling and ability of cytopathological diagnosis in solid pancreatic neoplasms and to determine usefulness and adverse events of combining both procedures. Material and methods: Two hundred and thirty four patients suspected to have solid pancreatic mass on abdominal ultrasound and/or computed tomography (CT) were enrolled. EUS-FNA (group A), ERCP cytology (group B) and combined procedures (Group C) performed in 105, 91 and 38 cases, respectively. Results: Sensitivity, specificity and accuracy were 98.9%, 93.3% and 98.1% for group A, and 72.1%, 60% and 71.4% for group B. Those for group C were all 100%. Sensitivity for malignancy in the pancreas head was 100% for group A and 82.4% for group B, and in the pancreas body and tail, 97.6% for group A and 57.1% for group B. EUS-FNA was more sensitive than ERCP cytology in diagnosing malignant pancreatic neoplasms 21–30?mm in size (p?=?0.0068), 31–40?mm (p?=?0.028) and?≥41?mm (p?0.0001). Sensitivity for pancreatic malignancy with group C was 100% regardless of mass location or size. Adverse events were 1.9%, 6.6% and 2.6% following EUS-FNA, ERCP and combined procedures, respectively. Conclusions: EUS-FNA is superior to ERCP cytology for diagnosis of solid pancreatic neoplasms. Although combination of both procedures provide efficient tissue diagnosis and with a minimal adverse events rate, a prospective study including larger number of patients is required. |
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Keywords: | cytopathological diagnosis endoscopic ultrasound-guided fine needle aspiration endoscopic retrograde cholangiopancreatography pancreatic neoplasm |
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