Percutaneous CT-guided fine needle aspiration cytology in the differential diagnosis of pancreatic lesions.
Cytologic results were retrospectively evaluated in 83 patients who underwent CT-guided fine-needle aspiration of pancreatic lesions during a 5-year period. Sixty seven patients had malignant disease and 16 benign disease. The sensitivity, specificity, positive and negative predictive values, and diagnostic efficiency of fine-needle aspiration (FNA) cytology in detecting malignancy were 91%, 100%, 100%, 73%, and 93%, respectively. In solid pancreatic masses the sensitivity of FNA cytology rose to 98%, while in cystic pancreatic masses sensitivity fell to 62%. In 18 patients with cystic lesions (12 benign and 6 malignant), the cystic fluid was analyzed for amylase, CEA and CA 19-9 content. Amylase levels were high in pseudocysts and in 4/6 malignant cysts. CEA levels were low in benign cysts, and high in all malignant cysts. CA 19-9 levels were high in one pseudocyst and in all malignant cysts. Tumour marker content analysis enhanced the sensitivity of the cytologic diagnosis of malignant cysts to 92%. FNA cytology is a simple and highly accurate method in the differential diagnosis of solid pancreatic lesions. In cystic lesions, tumour marker fluid content determination increases the sensitivity of FNA cytology.
Sperti
C
C
Instituto di Semeiotica Chirurgica, Università di Padova, Italy.
Pasquali
C
C
Di Prima
F
F
Rugge
M
M
Petrin
P
P
Costantino
V
V
Canton
A
A
Pedrazzoli
S
S
D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010182:Pancreatic Diseases / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology*; D010192:Pancreatic Pseudocyst / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor