Evaluation of diagnostic cytology via endoscopic naso-pancreatic drainage for pancreatic tumor

Table 1 Characteristics of patients undergoing endoscopic naso-pancreatic drainage tube and endoscopic naso-pancreatic drainage plus brush cytology

Daiagnostic ENPD (n = 35)
Age (yr)	69 (48-86)
Sex, M/F	21:14
ENPD-BC (n)	11
Frequency of brush in ENPD-BC (range)	1 (1-2)
Frequency of pancreatic juice cytology in ENPD-BC (range)	4 (2-5)
ENPD-C (n)	24
Frequency of ENPD-C (range)	3 (1-5)

Thirty-five patients underwent the cytology of pancreatic juice obtained via endoscopic naso-pancreatic drainage tube (ENPD-C) and ENPD-C with brush cytology (ENPD-BC). M/F: Male/female.

Table 2 Diagnostic, surgical methods and final diagnosis of pancreatic diseases

		No.
Operable	Pancreaticoduodenectomy	10
	Distal pancreatectomy	3
	Total pancreatectomy	1
	Palliative operation or exploratory laparotomy	4
Inoperable		17
Cancerous	Pancreatic cancer	16
	IPMN-CAN	3
	Others	2
Non-cancerous	IPMN-BEN	8
	Chronic pancreatitis	5
	Others	1

In 18 operable cases, the final diagnosis was confirmed on the basis of the resected specimen. In the 17 inoperable cases, it was diagnosed by follow-up findings at least 6 mo after endoscopic naso-pancreatic drainage (ENPD). The diagnosis of pancreatic ductal adenocarcinoma derived from the intraductal papillary mucinous neoplasm (IPMN-CAN) was only confirmed pathologically in consecutive lesions. We defined IPMN without the potential of cancer as IPMN-BEN.

Table 3 Sensitivity and specificity of pancreatic juice cytology

Cytology	Positive	Negative		Total
	Class V/IV	Class III	Class II/I
Cancerous	7	7	7	21
Non-cancerous	0	3	11	14

The sensitivity and specificity for all patients were 33.3% and 100%, respectively.

Table 4 Location and size of pancreatic cancer

	Pancreatic cancer
Total	16
Location
Ph	12
Pb	1
Pt	3
Size (range)	30 mm (15-54 mm)
Main pancreatic duct size (range)	3.5 mm (1-10 mm)

Ph: Head of pancreas; Pb: Body of pancreas; Pt: Tail of pancreas. Most pancreatic cancers were located in the pancreatic head (Ph) (12/16, 75.0%).

Table 5 Sensitivity and specificity of endoscopic naso-pancreatic drainage tube with brush cytology and endoscopic naso-pancreatic drainage tube, pancreatic juice cytology and characteristics of intraductal papillary mucinous neoplasm

ENPD-BC (Sensitivity: 50%; Specificity: 100%)	Positive	Negative		Total
11 cases	Class V/IV	Class III	Class II/I
Cancerous	4	3	1	8
Non-cancerous	0	1	2	3
ENPD-C (Sensitivity: 30.8%; Specificity: 100%)	Positive	Negative		Total
24 cases	Class V/IV	Class III	Class II/I
Cancerous	4	4	5	13
Non-Cancerous	0	3	8	11
Cytology in IPMN patients (Sensitivity: 33%; Specificity: 100%)	Positive	Negative		Total
	Class V/IV	Class III	Class II/I
Cancerous	1	1	1	3
Non-cancerous	0	2	6	8

IMPN: Intraductal papillary mucinous neoplasm.

Table 6 Characteristics of intraductal papillary mucinous neoplasm

	IPMN-CAN	IPMN-BEN	P value
Total	3	8
Main duct type	2	2	-
Branch duct type	1	6
Position
Ph, Pb, Pt	2, 0, 0	3, 1, 1	-
Pb + Pt	1	1
Ph + Pt		1
Ph + Pb + Pt		1
Size (range)	43 mm (32-75 mm)	17.5 mm (10-61 mm)	0.0811
Mural nodule + (%)	3 (100%)	3 (33%)	0.18182
Main pancreatic duct size (range)	6 mm (4-17 mm)	5 mm (3-15 mm)	0.52981

¹Mann-Whitney U test;

²χ² test. None of the differences between the two intraductal papillary mucinous neoplasm (IPMN) groups were significant (P≥ 0.05).