title: Long-term follow-up of patients with clinically indeterminate suspicion of pancreatic cancer and normal EUS.
abstract: BACKGROUND
  EUS often is performed because of a clinical suspicion of pancreatic cancer when the results of other noninvasive diagnostic tests are indeterminate. The aim of this study was to determine the true negative predictive value of a normal EUS in a cohort of patients with an indeterminate suspicion of pancreatic cancer by obtaining long-term follow-up information.
  
  
  METHODS
  Patients referred for EUS of the pancreas for the following indications were identified: elevated carbohydrate-associated antigen (CA 19-9) without other definitive evidence of pancreatic cancer, subtle abnormalities on CT of the pancreas, and unexplained abdominal pain and/or weight loss. Endoscopy procedure reports, as well as inpatient and outpatient records were obtained. In addition, referring physicians, as well as patients, were contacted to acquire adequate follow-up information.
  
  
  RESULTS
  A total of 80 patients were included in the study. Follow-up of at least 6 months was obtained for 76 (95%) patients (mean follow-up 23.9 months). No patient with a normal EUS of the pancreas developed pancreatic cancer or required pancreatic surgery during the follow-up period. One patient in whom a diagnosis of chronic pancreatitis was made by EUS subsequently was found to have pancreatic cancer at surgery.
  
  
  CONCLUSIONS
  A normal EUS of the pancreas in the setting of subtle radiologic findings, serologic abnormalities, and/or nonspecific symptoms definitively rules out the presence of pancreatic cancer.
authors.affiliation: University Hospitals of Cleveland-Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Catanzaro
authors.forename: Scott
authors.initials: S
authors.lastname: Richardson
authors.forename: Hazel
authors.initials: H
authors.lastname: Veloso
authors.forename: Gerard A
authors.initials: GA
authors.lastname: Isenberg
authors.forename: Richard C k
authors.initials: RC
authors.lastname: Wong
authors.forename: Michael V
authors.initials: MV
authors.lastname: Sivak
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chak
mesh_terms: D018395:CA-19-9 Antigen / Q000097:blood; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D010195:Pancreatitis / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests
chemical_list: D018395:CA-19-9 Antigen