title: Diagnostic yield and therapeutic impact of fine-needle aspiration biopsies guided by endoscopic ultrasound in pancreatic lesions.
abstract: OBJECTIVE
  The correct approach and treatment in a patient with a pancreatic lesion detected by imaging is not easy. Recently, the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy is becoming a useful tool. The aim of the study is to evaluate the diagnostic yield and therapeutic impact of EUS-FNA in pancreatic lesions.
  
  
  METHODS
  Fifty-three patients with focal pancreatic lesions underwent EUS-FNA from March 2005 to March 2006. The final diagnosis was confirmed by the histological analysis from the surgical specimen and/or clinical follow-up for at least 6 months.
  
  
  RESULTS
  . Fifty-two patients were evaluated. Forty-seven useful samples for histological evaluation were obtained. Adequate samples were obtained in 83.3% (5/6) for lesions < 20 mm, 100% (19/19) for lesions from 20 to < 40 mm and 85.1% (23/ 27) for those > or = 40 mm. To differentiate between benign/malignant disease the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EUS-FNA were 97.3% (95% CI: 84.9-99.1), 100% (95% CI: 66-100), 100% (95% CI: 88-100), 90% (95% CI: 57-96) and 97.8%, respectively. There was a change in the initial diagnosis in seven patients (14.8%). No complications were reported.
  
  
  CONCLUSIONS
  EUS-FNA is a useful and safe method with high predictive values to differentiate between malignant and benign pancreatic lesions.
authors.affiliation: Endoscopy Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City. mangelramirez@yahoo.com
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Ramírez-Luna
authors.forename: Sergio
authors.initials: S
authors.lastname: Zepeda-Gómez
authors.forename: Norberto C
authors.initials: NC
authors.lastname: Chávez-Tapia
authors.forename: Félix I
authors.initials: FI
authors.lastname: Téllez-Avila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods*; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D012189:Retrospective Studies