title: Yield of endoscopic ultrasound-guided fine needle aspiration and endoscopic retrograde cholangiopancreatography for solid pancreatic neoplasms.
abstract: OBJECTIVE
  Both endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic retrograde cholangiopancreatography (ERCP) cytology may provide tissue diagnoses in solid pancreatic neoplasms. However, there are scant data comparing these two methods. This study aims at retrospectively comparing EUS-FNA and ERCP tissue sampling and ability of cytopathological diagnosis in solid pancreatic neoplasms and to determine usefulness and adverse events of combining both procedures.
  
  
  METHODS
  Two hundred and thirty four patients suspected to have solid pancreatic mass on abdominal ultrasound and/or computed tomography (CT) were enrolled. EUS-FNA (group A), ERCP cytology (group B) and combined procedures (Group C) performed in 105, 91 and 38 cases, respectively.
  
  
  RESULTS
  Sensitivity, specificity and accuracy were 98.9%, 93.3% and 98.1% for group A, and 72.1%, 60% and 71.4% for group B. Those for group C were all 100%. Sensitivity for malignancy in the pancreas head was 100% for group A and 82.4% for group B, and in the pancreas body and tail, 97.6% for group A and 57.1% for group B. EUS-FNA was more sensitive than ERCP cytology in diagnosing malignant pancreatic neoplasms 21-30 mm in size (p = 0.0068), 31-40 mm (p = 0.028) and ≥ 41 mm (p < 0.0001). Sensitivity for pancreatic malignancy with group C was 100% regardless of mass location or size. Adverse events were 1.9%, 6.6% and 2.6% following EUS-FNA, ERCP and combined procedures, respectively.
  
  
  CONCLUSIONS
  EUS-FNA is superior to ERCP cytology for diagnosis of solid pancreatic neoplasms. Although combination of both procedures provide efficient tissue diagnosis and with a minimal adverse events rate, a prospective study including larger number of patients is required.
authors.affiliation: a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.|b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Malak
authors.affiliation: a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Masuda
authors.affiliation: a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ogura
authors.affiliation: a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.
authors.forename: Akira
authors.initials: A
authors.lastname: Imoto
authors.affiliation: b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt.
authors.forename: Usama M
authors.initials: UM
authors.lastname: Abdelaal
authors.affiliation: b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt.
authors.forename: Eman A
authors.initials: EA
authors.lastname: Sabet
authors.affiliation: b Department of Internal Medicine, Sohag Faculty of Medicine , Sohag University , Nasser city, Sohag , Egypt.
authors.forename: Lotfy H
authors.initials: LH
authors.lastname: Abo Dahab
authors.affiliation: a Second Department of Internal Medicine , Osaka Medical College , 2-7, Daigakumachi , Osaka , Japan and.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Higuchi
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: cytopathological diagnosis; endoscopic retrograde cholangiopancreatography; endoscopic ultrasound-guided fine needle aspiration; pancreatic neoplasm