Nigam Neha, Rastogi Archana, Bhatia Vikram, Sureka Binit, Jain Priyanka, Bihari Chhagan
Department of Pathology, SGPGIMS, Lucknow, Uttar Pradesh, India.
Department of Pathology, I.L.B.S., New Delhi, India.
J Cytol. 2019 Oct-Dec;36(4):189-195. doi: 10.4103/JOC.JOC_5_18. Epub 2019 Sep 20.
Early and accurate diagnosis is paramount for improving the therapeutic efficacy of pancreatic cancers. Endoscopic ultrasonography-fine needle aspiration (EUS-FNA) cytology has come up with the advantage of an early and accurate diagnosis of pancreatic cancers. This study was conducted to analyze the spectrum of pancreatic lesions cytology, and appraise the diagnostic accuracy of EUS-FNA cytology for pancreatic solid and cystic lesions.
This retrospective study includes 288 EUS-guided pancreatic FNA cases. Clinical data, laboratory tests, cytopathology, histopathology, and imaging reports were retrieved. The final diagnosis was based on EUS-FNA cell block and/or pathology in surgical specimens, with immunohistochemistry support. The results of EUS-guided FNA were compared with the final diagnoses to calculate the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Among 288 EUS-guided pancreatic FNA cases, 175 (62.0%) were malignant. The mean age was 57.8 ± 13.5 years and 50.1 ± 13.7 years, and the mean size of the lesion was 4.1 ± 1.8 cm and 2.2 ± 1.1 cm in malignant and benign groups, respectively. Sensitivity, specificity, PPV, and NPV of EUS-FNA cytology for solid malignant lesions were 98.3%, 95.1%, 98.3%, and 95.1%, and those for cystic lesions were 88%, 92.3%, 100%, and 100%. Diagnostic accuracy of EUS-FNA cytology for solid and cystic pancreatic lesions is 97.4% and 95.0%, respectively. In conclusion of the above; diagnosis of pancreatic solid and cystic malignancy can be assigned from a composite of the EUS-FNA cytology, cell block preparation and immunohistochemistry Diagnosis of pancreatic solid and cystic malignancy can be assigned from a composite of the EUS-FNA cytology, cell block preparation, and immunohistochemistry.
早期准确诊断对于提高胰腺癌的治疗效果至关重要。内镜超声引导下细针穿刺（EUS-FNA）细胞学检查具有早期准确诊断胰腺癌的优势。本研究旨在分析胰腺病变的细胞学谱，并评估EUS-FNA细胞学检查对胰腺实性和囊性病变的诊断准确性。
本回顾性研究纳入288例EUS引导下胰腺FNA病例。收集临床资料、实验室检查、细胞病理学、组织病理学及影像学报告。最终诊断基于EUS-FNA细胞块和/或手术标本病理，并辅以免疫组化。将EUS引导下FNA的结果与最终诊断进行比较，计算敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。
在288例EUS引导下胰腺FNA病例中，175例（62.0%）为恶性。恶性组和良性组的平均年龄分别为57.8±13.5岁和50.1±13.7岁，病变平均大小分别为4.1±1.8cm和2.2±1.1cm。EUS-FNA细胞学检查对实性恶性病变的敏感性、特异性、PPV和NPV分别为98.3%、95.1%、98.3%和95.1%，对囊性病变分别为88%、92.3%、100%和100%。EUS-FNA细胞学检查对胰腺实性和囊性病变的诊断准确性分别为97.4%和95.0%。综上所述，胰腺实性和囊性恶性肿瘤的诊断可通过EUS-FNA细胞学检查、细胞块制备及免疫组化综合判断。胰腺实性和囊性恶性肿瘤的诊断可通过EUS-FNA细胞学检查、细胞块制备及免疫组化综合判断。
