Cytologic examination and CEA measurement in aspirated pancreatic material collected by percutaneous fine-needle aspiration biopsy under ultrasonic guidance for the diagnosis of pancreatic carcinoma.

Diagnostic accuracy of the cytologic examination or CEA measurement in pancreatic fluid obtained by percutaneous fine-needle aspiration biopsy under ultrasonic guidance, was investigated in 26 patients with histologically proven carcinoma of the pancreas, and the incidence of positive results of cytology and CEA assay were compared in pancreatic fluid obtained by percutaneous fine-needle aspiration biopsy and by endoscopic cannulation of the ampulla of Vater in the same 19 patients. Positive cytologic findings were observed in the fluid obtained by percutaneous aspiration biopsy of 88.5% of the patients with pancreatic carcinoma. The location of the cancer had no influence on the cytology, but positive results were more frequent in patients with distant metastases than in those with localized tumor or locally invasive carcinoma. Positive cytologic results were obtained in the pancreatic fluid obtained by endoscopic cannulation from the ampulla of Vater of only 15.8% of the patients examined by both methods, but percutaneous fine-needle aspiration biopsy significantly increased the diagnostic rate. In the specimens obtained by aspiration biopsy, tumor cells were much more abundant and easily recognizable. When cytologic examination does not provide any evidence of malignancy, measurement of CEA levels in pancreatic fluid is probably useful. Combination of the cytology and CEA assay of the specimens obtained by percutaneous fine-needle aspiration biopsy of the pancreas increased the diagnostic rate to 100%.