title: Accuracy of endoscopic ultrasound in the evaluation of cystic pancreatic neoplasms: a community hospital experience.
abstract: OBJECTIVE
  Reports on the use of endoscopic ultrasound (EUS) in differentiating benign, premalignant, and malignant pancreatic lesions have been widely variable, particularly with cystic neoplasms. We evaluated the use of EUS for cystic pancreatic lesions in a community hospital setting.
  
  
  METHODS
  All patients who underwent EUS for cystic pancreatic neoplasms from 2007 to 2010 were reviewed. A final EUS diagnosis was determined based on the examiner's impression and fine-needle aspiration results if available. Lesions were stratified as benign, premalignant, or malignant. Patients underwent surgical resection, serial imaging studies, or medical oncology/palliative care consultation as indicated.
  
  
  RESULTS
  One hundred eighteen patients with cystic pancreatic lesions underwent EUS during the study period. Endoscopic ultrasound diagnoses included 75 benign (63.6%), 35 premalignant (29.7%), and 8 malignant (4.2%) lesions. Thirty-eight patients (32.2%) underwent surgery, 77 (65.3%) were monitored with imaging, and 3 (2.5%) had unresectable malignancies. Elevated carcinoembryonic antigen levels showed a trend toward predicting mucinous cysts (P = 0.062). Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for cystic lesions were 87.3%, 86.8%, 87.5%, 76.7%, and 93.3%, respectively.
  
  
  CONCLUSIONS
  Endoscopic ultrasound is a valuable diagnostic modality in the evaluation of cystic pancreatic neoplasms in a community hospital setting.
authors.affiliation: From the *Grand Rapids Medical Education Partners/Michigan State University General Surgery Residency Program; †Michigan State University College of Human Medicine; ‡Grand River Gastroenterology; §Mercy Health Saint Mary's Hospital; and ∥Spectrum Health Medical Group, Grand Rapids, MI.
authors.forename: Gerald Paul
authors.initials: GP
authors.lastname: Wright
authors.forename: Jay Bradley
authors.initials: JB
authors.lastname: Morrow
authors.forename: Michael
authors.initials: M
authors.lastname: Shaheen
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Goslin
authors.forename: Lorel
authors.initials: L
authors.lastname: Baatenburg
authors.forename: Mathew H
authors.initials: MH
authors.lastname: Chung
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000032:analysis; D018291:Cystadenoma, Mucinous / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography / Q000379:methods*; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D002272:Carcinoembryonic Antigen