title: Endoscopic ultrasonography-guided fine needle aspiration biopsy using 22-gauge needle in diagnosis of autoimmune pancreatitis.
abstract: BACKGROUND
  The effectiveness of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has not been fully evaluated in the diagnosis of autoimmune pancreatitis (AIP).
  
  
  OBJECTIVE
  To evaluate the effectiveness of EUS-FNA using 22-gauge needles in the diagnosis of AIP.
  
  
  METHODS
  EUS-FNA was examined in 85 patients with pancreatic mass, including 64 patients with pancreatic cancer and 21 patients with AIP. We investigated ability of EUS-FNA using 22-gauge needle for the differential diagnosis between AIP and pancreatic cancer. We also compared the factors concerning FNA procedures (number of needle passes, size of lesion, device, and amount of obtained pancreatic tissue) between two diseases.
  
  
  RESULTS
  Tissues obtained from 21 patients with AIP, although none of them demonstrated histology suspicious for malignancy, did not show histological evidence definitive for AIP. The amount of obtained pancreatic tissue was almost equal between two diseases in each pancreatic location. Sensitivity, specificity, overall accuracy, and negative predictive value of histological diagnosis of pancreatic cancer were 92.2%, 100%, 94.1%, and 80.8%, respectively.
  
  
  CONCLUSIONS
  EUS-FNA using 22-gauge needle distinguished benign from malignant pancreatic mass with >90% of accuracy, regardless of the location. Hence, it was helpful for the clinical diagnosis of AIP, however not providing satisfactory samples for the histological diagnosis of AIP.
authors: Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka 411-8777, Japan.
authors: Kenichiro
authors: K
authors: Imai
authors: Hiroyuki
authors: H
authors: Matsubayashi
authors: Akira
authors: A
authors: Fukutomi
authors: Katsuhiko
authors: K
authors: Uesaka
authors: Keiko
authors: K
authors: Sasaki
authors: Hiroyuki
authors: H
authors: Ono
mesh_terms: D000368:Aged; D001327:Autoimmune Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D044963:Biopsy, Fine-Needle / Q000295:instrumentation / Q000379:methods*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional