title: Pancreatic carcinomas smaller than 3.0 cm: endosonography (EUS) in diagnosis, staging and prediction of resectability.
abstract: BACKGROUND
  The size of a pancreatic carcinoma determines prognosis and resection. The aim of this study was to review our clinical experience with endoscopic ultrasound (EUS) in diagnosing and staging pancreatic tumours <3.0 in diameter.
  
  
  METHODS
  From February 1997 to October 2000 medical records and results of abdominal ultrasound (US), spiral computed tomography (CT) and EUS with fine-needle aspiration biopsy (FNA) were reviewed in 17 patients operated for histologically proven pancreatic adenocarcinoma measuring <or= 3.0 cm in diameter. The mean age of the patients was 64 years (range 42-76 years).
  
  
  RESULTS
  US identified a pancreatic lesion in 11/17 (65%) patients. Spiral CT showed a total of 16/17 (94%) patients with a lesion. EUS identified pancreatic tumour in all patients (100%), and tissue was obtained from 15/17 patients (88%). Mean tumour size was 2.5 cm (range 0.8-3.0 cm). EUS accuracy in evaluating the portal vessels was 78%, superior mesenteric artery 100%, tumour stage (T) 88%, isolated node stage (N) 65% and combined TN staging was 53%. Regarding resectability, EUS sensitivity was 88%, specificity 89%, negative predictive value 89%, positive predictive value 88% and accuracy 88%. Besides cytological material, EUS-FNA histological diagnosis was possible in 12/17 patients (71%). There was only one case of mild post-procedure acute pancreatitis.
  
  
  CONCLUSIONS
  EUS-FNA is safe and has high diagnostic (100%) and local staging (88%) accuracy in pancreatic cancers <3.0 cm in diameter.
authors.affiliation: Endoscopy Unit, Division of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: J C
authors.initials: JC
authors.lastname: Ardengh
authors.forename: G A
authors.initials: GA
authors.lastname: de Paulo
authors.forename: A P
authors.initials: AP
authors.lastname: Ferrari