Aspects of percutaneous fine-needle aspiration biopsy in the diagnosis of pancreatic carcinoma.
BACKGROUND
Morphologic verification of malignancy is usually a prerequisite before initiating nonsurgical therapy for pancreatic carcinoma. Fine-needle biopsy has been widely used, but the method has also been criticized because of inadequate sampling material and the risk of intra-abdominal seeding.


METHODS
Cytologic material from 334 patients with suspected pancreatic malignancy was evaluated with regard to the sensitivity, specificity, and overall accuracy of the technique. The outcome (positive versus negative yield of cancer cells) was also entered in a Cox bivariate regression analysis and tested against multiple prognostic variables.


RESULTS
In all, 270 patients had malignant disease, which was verified cytologically in 187. The sensitivity, specificity, and accuracy were 69%, 100%, and 75%, respectively. Statistically significant prognostic factors with regard to patient survival time were type of therapy (P <0.001), tumor location (P <0.001), jaundice (P <0.001), pain (P <0.001), and palpable mass (P <0.05).


CONCLUSIONS
Fine-needle aspiration biopsy is still found to be a safe and feasible method for diagnosing pancreatic cancer, providing the requisite diagnostic information before initiating nonsurgical therapy.
Linder
S
S
Department of Surgery, Stockholm Söder Hospital, Sweden.
Blåsjö
M
M
Sundelin
P
P
von Rosen
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis