title: Diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for suspected pancreatic malignancy in relation to the size of lesions.
abstract: OBJECTIVE
  Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate method for cytological confirmation of pancreatic malignancy, but it has been unknown whether its diagnostic accuracy for pancreatic lesions was affected by their size, location, or size of needles. Our aim was to investigate the accuracy of EUS-FNA for suspected pancreatic malignancy in relation to these factors, especially to the size of lesions.
  
  
  METHODS
  In a tertiary referral center, EUS-FNAs for 120 suspected pancreatic malignancies in 115 patients based on other imaging studies were evaluated retrospectively.
  
  
  RESULTS
  Overall accuracy of EUS-FNA was 96% (115/120), with sensitivity of 95% (76/80), specificity of 98% (39/40), positive predictive value of 99% (76/77), and negative predictive value of 91% (39/43). Accuracies for lesions less than 10mm, 11-20mm, 21-30mm, and more than 31mm were 96%, 95%, 96%, and 100%, respectively; those for lesions in the head, the body, and the tail of the pancreas were 96%, 95%, and 95%, respectively. Accuracies for 22-gauge and 25-gauge needle were 93% and 98%, respectively.
  
  
  CONCLUSIONS
  EUS-FNA was accurate in the evaluation of suspected pancreatic malignancy regardless of its size, location, or size of needles. It was useful also in the confirmation of small pancreatic malignancies less than 10mm.
authors.affiliation: Department of Gastroenterology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan Department of Cancer Survey, Osaka, Japan. uehara-hi@mc.pref.osaka.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uehara
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikezawa
authors.forename: Natsuko
authors.initials: N
authors.lastname: Kawada
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Fukutake
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Katayama
authors.forename: Rena
authors.initials: R
authors.lastname: Takakura
authors.forename: Yasuna
authors.initials: Y
authors.lastname: Takano
authors.forename: Osamu
authors.initials: O
authors.lastname: Ishikawa
authors.forename: Akemi
authors.initials: A
authors.lastname: Takenaka
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000295:instrumentation; D016009:Chi-Square Distribution; D019160:Endosonography; D004867:Equipment Design; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009339:Needles; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D047368:Tumor Burden; D018084:Ultrasonography, Interventional