[Endoscopic ultrasound-fine needle aspiration (EUS-FNA) for pancreatic lesions: effectiveness in clinical practice].
Endoscopic ultrasound-fine needle aspiration (EUS-FNA) was shown to be a highly reliable and a very effective diagnostic technique, both based on data from clinical trials and from large clinical practice studies. EUS-FNA results are reported to be in good-to-very good agreement with the final diagnosis, and the agreement significantly exceeded the chance agreement. The overall sensitivity and specificity of EUS and of EUS-FNA are very good. EUS-FNA is an effective diagnostic technique for the evaluation of pancreatic lesions, either reported with other imaging tests or suspected on the basis of clinical and biochemical features. EUS-FNA may be performed in most cases, and the results of EUS-FNA are particularly important for their excellent positive predictive value. Nonetheless, in a few cases EUS-FNA can not be feasible, or can give false negative or inconclusive


RESULTS
The main practical consequence is that before referring patients to surgeons or oncologists, EUS-FNA should be considered as the best diagnostic strategy, since tissue is still the issue' . In a prospective two-centers consecutive series from Italy, FNA did not give any false positive diagnoses of malignancy, and reduced the number of indeterminate diagnoses; moreover, FNA significantly increased the specificity of diagnosis, while sensitivity was unchanged.
Rocca
R
R
S.C. Gastroenterologia ed Endoscopia Digestiva, ASO Ordine Mauriziano, Torino. rodolforocca@tin.it
Daperno
M
M
Crocellà
L
L
Lavagna
A
A
Salvetto
M
M
D044963:Biopsy, Fine-Needle / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005189:False Positive Reactions; D006801:Humans; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology