Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions

• Published in: Journal of pathology and translational medicine Vol. 49; no. 1; pp. 52 - 60
• Main Authors: Baek, Hae Woon, Park, Min Jee, Rhee, Ye-Young, Lee, Kyoung Bun, Kim, Min A, Park, In Ae
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Pathologists, Korean Society for Cytopathology 01.01.2015; The Korean Society of Pathologists and The Korean Society for Cytopathology; Korean Society of Pathologists & the Korean Society for Cytopathology; 대한병리학회
• Subjects: Accuracy; Biopsy; Cancer surgery; Cancer therapies; Cellular biology; Diagnosis; Endoscopic ultrasound-guided fine needle aspiration cytology; Endoscopy; Histology; Hospitals; Medical imaging; Medical prognosis; Mortality; Original; Pancreas; Pancreatic cancer; Pathology; Patients; Tomography; Tumors; 병리학; Accuracy; Diagnosis; Endoscopic ultrasound-guided fine needle aspiration cytology; Pancreas
• ISSN: 2383-7837; 2383-7845; 2383-7845
• DOI: 10.4132/jptm.2014.10.26

Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.