In many institutions, computed tomography (CT)-guided percutaneous fine-needle aspiration (FNA) has become the procedure of choice for biopsies of pancreatic mass lesions. This method of biopsy and others, such as endoscopic retrograde cholangiopancreatography (ERCP) cytology, are problematic because of a substantial false-negative rate.
Researchers from Indiana University Medical Center, USA, investigated the yield of endoscopic ultrasonography-guided FNA biopsies in patients who had negative results on CT-guided biopsy or negative cytologic findings on ERCP sampling.
A total of 102 patients (median age, 65 years) underwent endoscopic ultrasonography-guided FNA biopsy.
|Endoscopic ultrasonography-guided FNA biopsy may play a role when all other methods fail.|
|Annals of Internal Medicine|
Surgical pathology or long-term follow-up (median, 24 months) was used to identify false-positive or false-negative results.
The median mass size was 3.5 cm x 2.7 cm. A median of 3.4 passes were performed. Cytologic results on endoscopic ultrasonography-guided FNA biopsy were positive in 57 patients, negative in 37, and inconclusive or nondiagnostic in 8. No false-positive results were observed.
A diagnosis of pancreatic cancer was subsequently confirmed in 3 patients who had tested negative (false-negative results) and 1 of the 8 patients with non-diagnostic results.
Self-limited complications occurred in 3 of the 102 patients.
The authors conclude that endoscopic-ultrasonography-guided FNA biopsy may play a valuable role in the evaluation of a pancreatic mass, when results on other biopsy methods are negative, but pancreatic cancer is suspected.