title: Factors determining diagnostic yield of endoscopic ultrasound guided fine-needle aspiration for pancreatic cystic lesions: a multicentre Asian study.
abstract: OBJECTIVE
  The purpose of this study was to determine (1) the diagnostic yield for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with pancreatic cystic lesions, (2) additional value of EUS-FNA over EUS alone in the diagnosis of pancreatic cysts, and (3) diagnostic sensitivity and specificity of EUS and EUS-FNA in the subset of patients where histopathology of surgical specimens were available.
  
  
  METHODS
  All patients who underwent EUS examination for the evaluation of pancreatic cystic lesions in six Asian centres were included in the study.
  
  
  RESULTS
  Of 298 patients with pancreatic cysts who underwent EUS, 132 (44.3 %) underwent FNA. In the entire cohort, pseudocysts and intraductal papillary mucinous neoplasm (IPMN) were the predominant cystic lesions. The cytologic yield of EUS-FNA was 47 %. On univariate analysis, factors associated with higher cytologic yield included vascular involvement on EUS, presence of solid cystic component, and increased number of needle passes during EUS-FNA. On multivariate analysis, presence of solid cystic components and increased number of needle passes during EUS-FNA were associated with higher diagnostic yield of EUS-FNA. For pancreatic cysts with a solid component, the diagnostic yield of EUS-FNA increased significantly from 44 % with one pass to 78 % with more than one pass (p = 0.016). In the absence of a solid component, the diagnostic yield was 29 % with one pass and was not significantly different from the diagnostic yield of 50 % with more than one pass, p = 0.081.
  
  
  CONCLUSIONS
  The cytologic yield of EUS-FNA was 47 %. When a solid component was present in the cyst, doing more than one pass during EUS-FNA increased its diagnostic yield.
authors: Department of Gastroenterology and Hepatology, National University Health System, 10 Kent Ridge Crescent, Singapore, 119260, Singapore.
authors: Lee Guan
authors: LG
authors: Lim
authors: Sandeep
authors: S
authors: Lakhtakia
authors: Tiing Leong
authors: TL
authors: Ang
authors: Charles K F
authors: CK
authors: Vu
authors: Frederick
authors: F
authors: Dy
authors: Vui Heng
authors: VH
authors: Chong
authors: Christopher J L
authors: CJ
authors: Khor
authors: Wee Chian
authors: WC
authors: Lim
authors: Bhavesh Kishor
authors: BK
authors: Doshi
authors: Shyam
authors: S
authors: Varadarajulu
authors: Kenjiro
authors: K
authors: Yasuda
authors: Jennie Y Y
authors: JY
authors: Wong
authors: Yiong Huak
authors: YH
authors: Chan
authors: Min En
authors: ME
authors: Nga
authors: Khek Yu
authors: KY
authors: Ho
mesh_terms: D000368:Aged; D001208:Asia; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010181:Pancreatic Cyst / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D010192:Pancreatic Pseudocyst / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology; D011446:Prospective Studies