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World J Gastroenterol. Jan 14, 2007; 13(2): 289-293
Published online Jan 14, 2007. doi: 10.3748/wjg.v13.i2.289
Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses
Julio Iglesias-Garcia, Enrique Dominguez-Munoz, Antonio Lozano-Leon, Ihab Abdulkader, Jose Larino-Noia, Jose Antunez, Jeronimo Forteza
Julio Iglesias-Garcia, Enrique Dominguez-Munoz, Jose Larino-Noia, Gastroenterology Department, University Hospital, Santiago de Compostela, Spain
Julio Iglesias-Garcia, Enrique Dominguez-Munoz, Antonio Lozano-Leon, Jose Larino-Noia, Foundation for Research in Digestive Diseases, Santiago de Compostela, Spain
Ihab Abdulkader, Jose Antunez, Jeronimo Forteza, Pathology Department, University Hospital, Santiago de Compostela, Spain
Author contributions: All authors contributed equally to the work.
Correspondence to: Julio Iglesias-García, Gastroenterology Department, University Hospital, c/Choupana s/n 15706 Santiago de Compostela, Spain. jiglesiasg@fienad.com
Telephone: +34-981-951364 Fax: +34-981-951365
Received: September 20, 2006
Revised: November 2, 2006
Accepted: December 6, 2006
Published online: January 14, 2007
Abstract

AIM: To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses.

METHODS: Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study.

RESULTS: Length of the core specimen obtained for histological analysis was 6.5 ± 5.3 mm (range 1-22 mm). Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%), with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%.

CONCLUSION: Adequate pancreatic core specimens for histological examination can be obtained by EUS-guided FNA. This technique is mainly useful for the diagnosis of different types of pancreatic tumours and evaluation of benign diseases.

Keywords: Endoscopic ultrasound; Fine needle aspiration; Cytology; Biopsy; Pancreatic cancer