title: Diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology of pancreatic lesions.
abstract: BACKGROUND
  Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas.
  
  
  METHODS
  We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis.
  
  
  RESULTS
  In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%.
  
  
  CONCLUSIONS
  EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Hae Woon
authors: HW
authors: Baek
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Min Jee
authors: MJ
authors: Park
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Ye-Young
authors: YY
authors: Rhee
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Kyoung Bun
authors: KB
authors: Lee
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: Min A
authors: MA
authors: Kim
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
authors: In Ae
authors: IA
authors: Park
keywords: Accuracy; Diagnosis; Endoscopic ultrasound-guided fine needle aspiration cytology; Pancreas