Brief Article
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World J Gastroenterol. Apr 21, 2013; 19(15): 2368-2373
Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2368
Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis
Masato Matsuyama, Hiroshi Ishii, Kensuke Kuraoka, Seigo Yukisawa, Akiyoshi Kasuga, Masato Ozaka, Sho Suzuki, Kouichi Takano, Yuko Sugiyama, Takao Itoi
Masato Matsuyama, Hiroshi Ishii, Kensuke Kuraoka, Seigo Yukisawa, Akiyoshi Kasuga, Masato Ozaka, Sho Suzuki, Kouichi Takano, Department of Gastroenterology, Cancer Institute Hospital, Tokyo 135-8550, Japan
Yuko Sugiyama, Department of Gynecology, Cancer Institute Hospital, Tokyo 135-8550, Japan
Takao Itoi, Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo 160-0023, Japan
Author contributions: Matsuyama M and Ishii H performed most of the examinations; Kuraoka K, Yukisawa S, Kasuga A, Ozaka M, Suzuki S and Takano K managed the patients; Sugiyama Y supported the cytopathology; Matsuyama M, Ishii H and Itoi T wrote the paper.
Correspondence to: Masato Matsuyama, MD, PhD, Department of Gastroenterology, Cancer Institute Hospital, 3-8-31, Ariake, Koto-ku, Tokyo 135-8550, Japan. mahsanmahsan2000@yahoo.co.jp
Telephone: +81-3-35200111  Fax: +81-3-35700111
Received: December 9, 2012
Revised: January 23, 2013
Accepted: February 5, 2013
Published online: April 21, 2013
Processing time: 131 Days and 3.6 Hours
Abstract

AIM: To clarify the effectiveness and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC).

METHODS: Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events.

RESULTS: Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P = 0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P = 0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%).

CONCLUSION: EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC.

Keywords: Endoscopic ultrasound-guided fine needle aspiration; Percutaneous needle aspiration; Pancreatic cancer