title: Evaluation of diagnostic cytology via endoscopic naso-pancreatic drainage for pancreatic tumor.
abstract: OBJECTIVE
  To evaluate the usefulness of cytology of the pancreatic juice obtained via the endoscopic naso-pancreatic drainage tube (ENPD-C).
  
  
  METHODS
  ENPD was performed in cases where a diagnosis could not be made other than by using endoscopic retrograde cholangiopancreatography and in cases of pancreatic neoplasms or cystic tumors, including intraductal papillary mucinous neoplasm (IPMN) suspected to have malignant potential. 35 patients (21 males and 14 females) underwent ENPD between January 2007 and June 2013. The pancreatic duct was imaged and the procedure continued in one of ENPD-C or ENPD-C plus brush cytology (ENPD-BC). We checked the cytology result and the final diagnosis.
  
  
  RESULTS
  The mean patient age was 69 years (range, 48-86 years). ENPD-C was performed in 24 cases and ENPD-C plus brush cytology (ENPD-BC) in 11 cases. The ENPD tube was inserted for an average of 3.5 d. The final diagnosis was confirmed on the basis of the resected specimen in 18 cases and of follow-up findings at least 6 mo after ENPD in the 18 inoperable cases. Malignancy was diagnosed in 21 cases and 14 patients were diagnosed as having a benign condition. The ratios of class V/IV:III:II/I findings were 7:7:7 in malignant cases and 0:3:11 in benign cases. The sensitivity and specificity for all patients were 33.3% and 100%, respectively. The cytology-positive rate was 37.5% (6/16) for pancreatic cancer. For IPMN cases, the sensitivity and specificity were 33% and 100%, respectively.
  
  
  CONCLUSIONS
  Sensitivity may be further increased by adding brush cytology. Although we can diagnosis cancer in cases of a positive result, the accuracy of ENPD-C remains unsatisfactory.
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Iwata
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamiya
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ishii
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nomoto
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Ikegami
authors.affiliation: Tomoyuki Iwata, Katsuya Kitamura, Akira Yamamiya, Yu Ishii, Yoshiki Sato, Tomohiro Nomoto, Akitoshi Ikegami, Hitoshi Yoshida, Division of Gastroenterology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yoshida
keywords: Cytology; Endoscopic naso-pancreatic drainage; Intraductal papillary mucinous neoplasm; Pancreatic cancer; Pancreatic juice