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a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2013; 67(5): 431-437.

Endosonography-guided fine needle aspiration biopsy of solid pancreatic masses - accuracy and impact on the treatment of 358 patients

Martin Kliment  1, Ondřej Urban  2,3, Martin Loveček  4, Martin Straka  5, Dušan Žiak  6, Přemysl Falt  7, Petr Fojtík  8, Jana Dvořáčková  

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The aim of our study was to evaluate the accuracy, safety and benefit of EUS-FNA in diagnosing and treating patients with unclear solid pancreatic mass. Diagnostic accuracy of EUS-FNA was evaluated through the comparison of EUS-FNA cytology with either histology of rescted specimen or clinical and radiological follow-up. The benefit was defined as impact of EUS-FNA cytology on subsequent treatment. In a cohort of 358 patients with a solid pancreatic mass, the sensitivity and specificity of EUS-FNA in diagnosing pancreatic cancer was 93% (95% Cl: 89.2-95.6) and 90.1% (95% Cl: 80.1-95.6), respectively. Complications ocured in 2.2% of patients. False-negative cytology was less frequent in EUS-FNA with rapid on-site cytopathology evaluation (ROSE) compared with EUS-FNA without ROSE (3.9% vs 14.3%; p = 0.006). The positive and negative impact of EUS-FNA on subsequent treatment was observed in 63.9% and 0.5% of patients, respectively. In 3.4% of patients with pancreatic cancer, EUS-FNA diagnosed either subtle malignant ascites or liver metastases (mean ± SD: 8,9 ± 3,5 mm), that were not detected on previous contrast-enhanced CT scans. We have confirmed that EUS-FNA is accuarate and safe method in diagnosing pancreas carcinoma and has positive impact on subsequent treatment in 2/3 of patients with unclear solid pancreatic mass. ROSE significantly increases the accuracy of the method.


endosonography, pancreatic cancer

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