[Utility of rapid on-site cytology in endoscopic ultrasonography-guided fine needle aspiration of pancreatic masses].

BACKGROUND

Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) is a safe and effective method for obtaining samples for cytological diagnosis. Pancreatic cancer is extremely serious and often extremely aggressive, so early detection and diagnosis is important. Therefore, we actively perform EUS FNA for pathological diagnosis of cancer of digestive organs, especially the pancreas.

MATERIALS AND METHODS

EUS-FNA was performed in 67 patients (39 male, 28 female, median age 63.3 years) from January 2007 to December 2010 in Kyoto University Hospital. To eliminate both quantitatively and qualitatively inadequate samples, we performed EUS-FNA with rapid on-site cytology. Two squash preparations of the collected cells from biopsy were retrieved. One was stained on-site with Giemsa for rapid cytology to evaluate the quantity and quality of the cell collection. If necessary, second or third trials were carried out to obtain appropriate samples for final cytology diagnosis. The other was wet-fixed and used for Papanicolaou staining.

RESULTS

All 11 cases of inflammatory disease were diagnosed as negative on cytology. Solid-pseudopapillary neoplasm (1 case) and Endocrine neoplasms (3 cases) were correctly diagnosed on cytology. In pancreatic cancer, 49 of 52 cases (94%) were diagnosed as positive, but 3 cases (6%) were false-negative on cytology. The number of centesis for sampling was once in 21 cases, twice in 26 cases and more than twice in 20 cases. In this study of EUS-FNA, sensitivity was 94% and specificity was 100%.

CONCLUSION

Results of our examination suggest that the combination of EUS-FNA and rapid on-site cytology is a highly specific and sensitive test for detection of pancreatic cancer, and may contribute to reduce excessive centesis.