The clinical utility of endoscopic ultrasound–guided fine-needle aspiration in the diagnosisand staging of pancreatic carcinoma☆,☆☆,★,★★
Section snippets
Patients and Methods
Forty-four consecutive patients (24 men, 20 women) underwent EUS-guided FNA procedures between April 1993 and November 1995. The mean age of the patients was 61 years with a range from 28 to 88 years. The indication for EUS-guided FNA was a pancreatic lesion seen initially on CT (17), ERCP (19), or EUS (8). The inclusion criteria included patients with a clinical suspicion of pancreatic cancer who were referred for a diagnosis as well as those who had an established diagnosis of pancreatic
Results
Forty-four patients underwent EUS-guided FNA procedures; there were 47 pancreatic lesions (39 head/neck, 5 body, and 3 tail). In 13 patients, periluminal lymph nodes were also sampled, of which five lymph nodes were celiac.
CT detected pancreatic lesions in 15 of 47 (32%), thereby missing the diagnosis in 32 of 47 (68%). However, in 13 of the 32 cases in which no focal pancreatic lesion was detected on CT, there was nonspecific enlargement of the pancreas. Of the 17 patients in whom a pancreatic
Discussion
EUS has been used in the diagnosis of pancreatic tumors with a high sensitivity and specificity. 1, 3, 4, 5, 6 It has also been used in local tumor staging of pancreatic cancer to predict resectability. 1 However, EUS cannot always differentiate malignant from inflammatory processes of the pancreas or lymph nodes. In one large series, EUS was only 76% accurate in the diagnosis of malignancy and 46% accurate in focal inflammation.3 Therefore, EUS-guided FNA with its ability to provide a tissue
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Cited by (0)
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From the Division of Gastroenterology, University of California, Irvine Medical Center, Irvine, and the Veterans Affairs Medical Center, Long Beach, California.
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This project sponsored in part by a research grant from Pentax Precision Instruments.
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Reprint requests: Kenneth J. Chang, MD, UCI Clinical Cancer Center, 101 The City Dr., Bldg. 23, Rt. 81, Orange, CA 92868.
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