title: Ultrasound-guided vs endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer diagnosis.
abstract: OBJECTIVE
  To clarify the effectiveness and safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for the diagnosis of pancreatic cancer (PC).
  
  
  METHODS
  Patients who were diagnosed with unresectable, locally advanced or metastatic PC between February 2006 and September 2011 were selected for this retrospective study. FNA biopsy for pancreatic tumors had been performed percutaneously under extracorporeal ultrasound guidance until October 2009; then, beginning in November 2009, EUS-FNA has been performed. We reviewed the complete medical records of all patients who met the selection criteria for the following data: sex, age, location and size of the targeted tumor, histological and/or cytological findings, details of puncture procedures, time from day of puncture until day of definitive diagnosis, and details of severe adverse events.
  
  
  RESULTS
  Of the 121 patients who met the selection criteria, 46 had a percutaneous biopsy (Group A) and 75 had an EUS-FNA biopsy (Group B). Adequate cytological specimens were obtained in 42 Group A patients (91.3%) and all 75 Group B patients (P = 0.0192), and histological specimens were obtained in 41 Group A patients (89.1%) and 65 Group B patients (86.7%). Diagnosis of malignancy by cytology was positive in 33 Group A patients (78.6%) and 72 Group B patients (94.6%) (P = 0.0079). Malignancy by both cytology and pathology was found in 43 Group A (93.5%) and 73 Group B (97.3%) patients. The mean period from the puncture until the cytological diagnosis in Group B was 1.7 d, which was significantly shorter than that in Group A (4.1 d) (P < 0.0001). Severe adverse events were experienced in two Group A patients (4.3%) and in one Group B patient (1.3%).
  
  
  CONCLUSIONS
  EUS-FNA, as well as percutaneous needle aspiration, is an effective modality to obtain cytopathological confirmation in patients with advanced PC.
authors.affiliation: Department of Gastroenterology, Cancer Institute Hospital, Tokyo 135-8550, Japan. mahsanmahsan2000@yahoo.co.jp
authors.forename: Masato
authors.initials: M
authors.lastname: Matsuyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishii
authors.forename: Kensuke
authors.initials: K
authors.lastname: Kuraoka
authors.forename: Seigo
authors.initials: S
authors.lastname: Yukisawa
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kasuga
authors.forename: Masato
authors.initials: M
authors.lastname: Ozaka
authors.forename: Sho
authors.initials: S
authors.lastname: Suzuki
authors.forename: Kouichi
authors.initials: K
authors.lastname: Takano
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
mesh_terms: D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*
keywords: Endoscopic ultrasound-guided fine needle aspiration; Pancreatic cancer; Percutaneous needle aspiration