title: Diagnostic ability and factors affecting accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic solid lesions: Japanese large single center experience.
abstract: BACKGROUND
  Several studies have investigated the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for pancreatic lesions, but they have included only limited patient populations. This study aimed to clarify the diagnostic accuracy of EUS-FNA in a large number of pancreatic lesions, and to describe the factors that influence it.
  
  
  METHODS
  From March 1997 to May 2010, 944 consecutive patients who had undergone EUS-FNA for pancreatic solid lesions were evaluated retrospectively. Factors affecting EUS-FNA accuracy were then analyzed.
  
  
  RESULTS
  A total of 996 solid pancreatic lesions were sampled by EUS-FNA. The overall sampling adequacy and diagnostic accuracy of these lesions were 99.3 % (989/996) and 91.8 % (918/996), respectively. The sensitivity and specificity for differentiating malignant from benign lesions were 91.5 % (793/867) and 97.7 % (126/129), respectively. The diagnostic performance was significantly higher when both cytological and cell-block examinations were carried out than with only cytological examination. In multivariate analysis, final diagnosis, location of lesion, lesion size, availability of on-site cytopathological evaluation, and experience of EUS-FNA procedure were independent factors affecting the accuracy of EUS-FNA. On-site cytopathological evaluation and lesion size were found to be the most weighted factors affecting diagnostic accuracy.
  
  
  CONCLUSIONS
  EUS-FNA for pancreatic solid lesions yielded a high accuracy and low complication rate. Both cytological and cell-block preparations and on-site cytopathological evaluation contributed to improve the accuracy. The diagnostic ability of EUS-FNA was less for smaller lesions, and repeated procedures may be needed if malignancy is suspected.
authors.affiliation: Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, 464-8681, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Haba
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamao
authors.forename: Vikram
authors.initials: V
authors.lastname: Bhatia
authors.forename: Nobumasa
authors.initials: N
authors.lastname: Mizuno
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hara
authors.forename: Susumu
authors.initials: S
authors.lastname: Hijioka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Imaoka
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Niwa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tajika
authors.forename: Shinya
authors.initials: S
authors.lastname: Kondo
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tanaka
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.forename: Waki
authors.initials: W
authors.lastname: Hosoda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawakami
authors.forename: Naoya
authors.initials: N
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult