title: High-resolution endoscopic ultrasound imaging and the number of needle passages are significant factors predicting high yield of endoscopic ultrasound-guided fine needle aspiration for pancreatic solid masses without an on-site cytopathologist.
abstract: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the accurate diagnostic method for pancreatic masses and its accuracy is affected by various FNA methods and EUS equipment. Therefore, we aimed to elucidate the instrumental and methodologic factors for determining the diagnostic yield of EUS-FNA for pancreatic solid masses without an on-site cytopathology evaluation.We retrospectively reviewed the medical records of 260 patients (265 pancreatic solid masses) who underwent EUS-FNA. We compared historical conventional EUS groups with high-resolution imaging devices and finally analyzed various factors affecting EUS-FNA accuracy.In total, 265 pancreatic solid masses of 260 patients were included in this study. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNA for pancreatic solid masses without on-site cytopathology evaluation were 83.4%, 81.8%, 100.0%, 100.0%, and 34.3%, respectively. In comparison with conventional image group, high-resolution image group showed the increased accuracy, sensitivity and specificity of EUS-FNA (71.3% vs 92.7%, 68.9% vs 91.9%, and 100% vs 100%, respectively). On the multivariate analysis with various instrumental and methodologic factors, high-resolution imaging (P = 0.040, odds ratio = 3.28) and 3 or more needle passes (P = 0.039, odds ratio = 2.41) were important factors affecting diagnostic yield of pancreatic solid masses.High-resolution imaging and 3 or more passes were the most significant factors influencing diagnostic yield of EUS-FNA in patients with pancreatic solid masses without an on-site cytopathologist.
authors.affiliation: aDepartment of Internal Medicine, Catholic Kwandong University International St. Mary's Hospital bDepartment of Internal Medicine, Gachon University School of Medicine, Gil Medical Center, Incheon, Korea.
authors.forename: Seok Hoo
authors.initials: SH
authors.lastname: Jeong
authors.forename: Hyun Hwa
authors.initials: HH
authors.lastname: Yoon
authors.forename: Eui Joo
authors.initials: EJ
authors.lastname: Kim
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yeon Suk
authors.initials: YS
authors.lastname: Kim
authors.forename: Jae Hee
authors.initials: JH
authors.lastname: Cho
mesh_terms: D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000706:statistics & numerical data*; D019160:Endosonography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000473:pathology*; D012189:Retrospective Studies