Factors Determining Diagnostic Yield of Endoscopic Ultrasound Guided Fine-Needle Aspiration for Pancreatic Cystic Lesions: A Multicentre Asian Study.

Autor: Lim, Lee, Lakhtakia, Sandeep, Ang, Tiing, Vu, Charles, Dy, Frederick, Chong, Vui, Khor, Christopher, Lim, Wee, Doshi, Bhavesh, Varadarajulu, Shyam, Yasuda, Kenjiro, Wong, Jennie, Chan, Yiong, Nga, Min, Ho, Khek
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Zdroj: Digestive Diseases & Sciences; Jun2013, Vol. 58 Issue 6, p1751-1757, 7p
Abstrakt: Background and Aim: The purpose of this study was to determine (1) the diagnostic yield for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with pancreatic cystic lesions, (2) additional value of EUS-FNA over EUS alone in the diagnosis of pancreatic cysts, and (3) diagnostic sensitivity and specificity of EUS and EUS-FNA in the subset of patients where histopathology of surgical specimens were available. Methods: All patients who underwent EUS examination for the evaluation of pancreatic cystic lesions in six Asian centres were included in the study. Results: Of 298 patients with pancreatic cysts who underwent EUS, 132 (44.3 %) underwent FNA. In the entire cohort, pseudocysts and intraductal papillary mucinous neoplasm (IPMN) were the predominant cystic lesions. The cytologic yield of EUS-FNA was 47 %. On univariate analysis, factors associated with higher cytologic yield included vascular involvement on EUS, presence of solid cystic component, and increased number of needle passes during EUS-FNA. On multivariate analysis, presence of solid cystic components and increased number of needle passes during EUS-FNA were associated with higher diagnostic yield of EUS-FNA. For pancreatic cysts with a solid component, the diagnostic yield of EUS-FNA increased significantly from 44 % with one pass to 78 % with more than one pass ( p = 0.016). In the absence of a solid component, the diagnostic yield was 29 % with one pass and was not significantly different from the diagnostic yield of 50 % with more than one pass, p = 0.081. Conclusion: The cytologic yield of EUS-FNA was 47 %. When a solid component was present in the cyst, doing more than one pass during EUS-FNA increased its diagnostic yield. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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