Chaudhary Dimple, Banga Priyanka, Sakhuja Puja, Goyal Surbhi, Saran Ravindra K, Batra Vineeta V, Srivastava Siddharth, Agarwal Anil K
Department of Pathology, GIPMER, New Delhi, India.
Gastroenterology Department, GIPMER, New Delhi, India.
Diagn Cytopathol. 2023 Feb;51(2):105-116. doi: 10.1002/dc.25058. Epub 2022 Sep 27.
Majority of the pancreatic cancer patients present at an advanced stage and have poor 5 year survival rate. Thus, there is a need for early detection of pancreatic cancer with the initiation of the therapy.
MATERIALS & METHODS: This is a retrospective study including all the endoscopic ultrasound guided (EUS) guided pancreatic FNAs from 2016 to 2020. The aspirate smears were analyzed and classified according to The Papanicolaou Society of Cytopathology System for Reporting Pancreaticobiliary Cytology (PSCPC).
A total of 245 EUS guided FNAs from pancreatic lesions were included. Cyto-histological correlation was done wherever available. Category I (non diagnostic) accounted for 40 cases (16%) cases, Category II (negative) comprised of 44 cases (18%); and Category III (Atypical) had 5 cases (2%). Category IV neoplastic-benign category included 3 cases of serous cystadenoma, while neoplastic-others category included pancreatic neuroendocrine tumors (n = 21), solid pseudo-papillary neoplasms (SPEN) (n = 12) and mucinous cystic neoplasms (n = 4). A total of 7 cases (2.8%) were reported in Category V (Suspicious). A diagnosis of adenocarcinoma (Category VI) was rendered in 105 cases (42.8%) cases. Rarer types included non Hodgkins lymphoma (n = 3) and one case of primary undifferentiated carcinoma with osteoclastic giant cells. Cyto-histological correlation in all categories was available in 58 cases with 8 false negative cases. Thus overall sensitivity of EUS guided FNAC was found to be 87.8% with a diagnostic yield of 83.6% while sensitivity in diagnosing adenocarcinoma was 96.9%.
The present study highlights the spectrum of EUS guided FNA of pancreatic lesions in a subset of North Indian population and classified them according to PSCPC. EUS guided FNAC is a sensitive investigation which plays a crucial role in confirming the diagnosis of pancreatic space occupying lesions (SOLs) in advanced stage.
大多数胰腺癌患者就诊时已处于晚期，5年生存率较低。因此，需要在治疗开始时早期检测胰腺癌。
这是一项回顾性研究，纳入了2016年至2020年所有经内镜超声引导（EUS）的胰腺细针穿刺活检（FNA）病例。根据细胞病理学学会胰腺胆管细胞学报告系统（PSCPC）对吸出物涂片进行分析和分类。
共纳入245例经EUS引导的胰腺病变FNA病例。尽可能进行了细胞组织学相关性分析。I类（非诊断性）占40例（16%），II类（阴性）包括44例（18%）；III类（非典型）有5例（2%）。IV类肿瘤-良性类别包括3例浆液性囊腺瘤，而肿瘤-其他类别包括胰腺神经内分泌肿瘤（n = 21）、实性假乳头状肿瘤（SPEN）（n = 12）和黏液性囊性肿瘤（n = 4）。V类（可疑）共报告7例（2.8%）。105例（42.8%）诊断为腺癌（VI类）。罕见类型包括非霍奇金淋巴瘤（n = 3）和1例伴有破骨细胞巨细胞的原发性未分化癌。58例各分类均有细胞组织学相关性分析，其中8例假阴性。因此，EUS引导的FNA总体敏感性为87.8%，诊断率为83.6%，而诊断腺癌的敏感性为96.9%。
本研究突出了北印度部分人群中经EUS引导的胰腺病变FNA的情况，并根据PSCPC进行了分类。EUS引导的FNA是一项敏感的检查，在确诊晚期胰腺占位性病变（SOL）中起着关键作用。
