[Result and efficacy of endoscopic ultrasound guided FNA in patients with solid pancreatic neoplasm]

ABSTRACT

Endosonography is a distinct method in evaluating gastrointestinal [GI] structural lesions, particularly in the pancreatobiliary system. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesions through fine needle aspiration [FNA]. This study aims to evaluate the results and efficacy of endosonographic fine needle aspiration [EUS-FNA] in patients presenting with solid pancreatic masses. This was a descriptive, prospective, case series study of patients who presented with solid pancreatic masses to Imam Khomeini Hospital, Tehran, Iran over a one year period [from November 2009-2010] In order to determine false negative cases, patients were followed for 6 to 12 months. A total of 53 patients underwent EUS-FNA with no complications. The results were diagnostic in 46 [87%] cases. The majority of patients were male [68%] and 81% had a mass in the pancreatic head. Cytopathology results revealed 36 [68%] adenocarcinomas, 7 [13%] other malignancies, 3 [6%] benign lesions and 7 [13%] nondiagnostic cases. The frequency of nondiagnostic results was significantly more in masses smaller than 3 cm [6 vs. 1, p < 0.002]. Patients with nondiagnostic results were younger than those with malignant cytopathologies [52 +/- 7.5 vs. 66 +/- 7.5 years, p < 0.001]. Sensitivity, specificity, PPV, NPV and accuracy of EUS-FNA in adenocarcinoma cases were 88%, 100%, 100%, 70% and 90%, respectively. EUS-FNA is an effective and safe procedure in the histopathologic diagnosis of pancreatic tumors