OBJECTIVETo inquiry into clinical-pathological factors influencing cytological accuracy of pancreatic head lesions.

METHODSCytology was retrospectively evaluated in 94 inpatients with a mass in head of pancreas existing with chronic pancreatitis in the past decade, the results of cytology were compared with clinical pathology or clinical follow-up to estimate the value and accuracy of cytology in detecting pancreatic cancer. Pancreatic clinical-pathology includes size of mass and component of mass which was composed of cancerous mode of development including shape of conglomeration, nest and pervasion, and pancreatic ductal epithelium inside the vicinity of 1 cm around the mass. Pancreatic ductal epithelium were divided into PanIN1, PanIN2 and PanIN3 three types according to classified criterion of pancreatic intraepithelial neoplasia (PanIN).

RESULTForty-six patients were pathologically diagnosed as pancreatic cancer and five patients as chronic pancreatitis, accordingly, 29 malignant, 5 suspicious, 10 atypical hyperplasia among of them 5 malignant, 3 hyperplastic ductal epithelium, 1 nondiagnostic results due to interfered by blood and 3 insufficient specimens. 43 patients were clinically diagnosed as chronic pancreatitis. Cytologic evaluation of pancreatic cancer has an 84.2% accuracy less than or equal to 2.5 cm and 71.9% larger than 2.5 cm. Shape of conglomeration, and nest have more accurate than pervasion in cytological diagnosis.

CONCLUSIONSCancerous mode of development is a vital factor influencing accuracy of cytology, cytological estimation of atypical hyperplasia and is still waiting for further investigation.