Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi, Suntogun, Shizuoka 411-8777, Japan.
Dig Liver Dis. 2011 Nov;43(11):869-74. doi: 10.1016/j.dld.2011.05.021. Epub 2011 Jul 5.
The effectiveness of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has not been fully evaluated in the diagnosis of autoimmune pancreatitis (AIP).
To evaluate the effectiveness of EUS-FNA using 22-gauge needles in the diagnosis of AIP.
EUS-FNA was examined in 85 patients with pancreatic mass, including 64 patients with pancreatic cancer and 21 patients with AIP. We investigated ability of EUS-FNA using 22-gauge needle for the differential diagnosis between AIP and pancreatic cancer. We also compared the factors concerning FNA procedures (number of needle passes, size of lesion, device, and amount of obtained pancreatic tissue) between two diseases.
Tissues obtained from 21 patients with AIP, although none of them demonstrated histology suspicious for malignancy, did not show histological evidence definitive for AIP. The amount of obtained pancreatic tissue was almost equal between two diseases in each pancreatic location. Sensitivity, specificity, overall accuracy, and negative predictive value of histological diagnosis of pancreatic cancer were 92.2%, 100%, 94.1%, and 80.8%, respectively.
EUS-FNA using 22-gauge needle distinguished benign from malignant pancreatic mass with >90% of accuracy, regardless of the location. Hence, it was helpful for the clinical diagnosis of AIP, however not providing satisfactory samples for the histological diagnosis of AIP.
内镜超声引导下细针抽吸（EUS-FNA）在自身免疫性胰腺炎（AIP）的诊断中的有效性尚未得到充分评估。
评估使用 22 号针的 EUS-FNA 在 AIP 诊断中的有效性。
对 85 例胰腺肿块患者进行了 EUS-FNA 检查，其中胰腺癌 64 例，AIP 21 例。我们研究了使用 22 号针的 EUS-FNA 在 AIP 与胰腺癌之间的鉴别诊断能力。我们还比较了两种疾病之间与 FNA 程序相关的因素（穿刺针数、病变大小、器械和获得的胰腺组织量）。
21 例 AIP 患者的组织均未显示恶性组织学特征，但也未显示明确的 AIP 组织学证据。两种疾病在每个胰腺位置获得的胰腺组织量几乎相等。胰腺癌的组织学诊断的灵敏度、特异性、总准确性和阴性预测值分别为 92.2%、100%、94.1%和 80.8%。
使用 22 号针的 EUS-FNA 能够以 >90%的准确率区分良性和恶性胰腺肿块，与位置无关。因此，它有助于 AIP 的临床诊断，但不能为 AIP 的组织学诊断提供满意的样本。
