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Factors affecting endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions

The most recent issue of the Journal of Gastroenterology investigates the diagnostic ability and factors affecting accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions.

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Several studies have investigated the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic lesions, but they have included only limited patient populations.

Dr Shin Haba and colleagues clarified the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration in a large number of pancreatic lesions, and described the factors that influence it.

From 1997 to 2010, there were 944 consecutive patients who had undergone endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions were evaluated retrospectively.

The researchers analyzed factors affecting endoscopic ultrasound-guided fine needle aspiration accuracy.

Diagnostic accuracy of these lesions was 92%
Journal of Gastroenterology

A total of 996 solid pancreatic lesions were sampled by endoscopic ultrasound-guided fine needle aspiration.

The overall sampling adequacy and diagnostic accuracy of these lesions were 99% and 92%, respectively.

The team found that the sensitivity and specificity for differentiating malignant from benign lesions were 92% and 98%, respectively.

The diagnostic performance was significantly higher when both cytological and cell-block examinations were carried out than with only cytological examination.

In multivariate analysis, final diagnosis, location of lesion, lesion size, availability of on-site cytopathological evaluation, and experience of endoscopic ultrasound-guided fine needle aspiration procedure were independent factors affecting the accuracy of endoscopic ultrasound-guided fine needle aspiration.

The team observed that on-site cytopathological evaluation and lesion size were the most weighted factors affecting diagnostic accuracy.

Dr Haba and colleagues conclude, "Endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions yielded a high accuracy and low complication rate."

"Both cytological and cell-block preparations and on-site cytopathological evaluation contributed to improve the accuracy."

"The diagnostic ability of endoscopic ultrasound-guided fine needle aspiration was less for smaller lesions, and repeated procedures may be needed if malignancy is suspected."

J Gastroenterol 2013: 48(8): 973-981
13 September 2013

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