Diagnostic value of endoscopic ultrasound guided fine needle aspiration combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions
10.3760/cma.j.issn.0254-1432.2017.12.007
- VernacularTitle:超声内镜引导下细针穿刺结合巴氏细胞学分级诊断胰腺实性病变的价值
- Author:
Qiao YE
1
;
Ke CHEN
;
Qianqian LIU
;
Liu YU
;
Shubei WANG
;
Ying XU
;
Tingjun YE
;
Yunwei SUN
Author Information
1. 200025,上海交通大学医学院附属瑞金医院消化内科
- Keywords:
EUS-FNA;
Solid pancreatic lesion;
Diagnosis;
Cytology
- From:
Chinese Journal of Digestion
2017;37(12):823-827
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the diagnostic value of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) combined with the new category of papanicolaou society of cytopathology in solid pancreatic lesions (SPL) rapid on-site evaluation (ROSE).Methods From February 2011 to October 2014,225 patients with SPL who underwent EUS-FNA and obtained the cytological diagnosis were enrolled.The lesions were finally diagnosed according to pathological results,imaging and follow-up data,and then the sensitivity,specificity,and accuracy of EUS-FNA in the diagnosis of SPL were calculated based on the new papanicolaou society of cytopathology terminology.Logistic stepwise regression analysis was performed to analyze the risk factors.Results Among 225 patients with SPL,96 cases (42.7％)had uncertain cytological diagnosis,17.3％ (39/225) could not be diagnosed,8.0％ (18/225) were atypical lesions,and 17.3％ (39/225) were suspicious malignant carcinomas.Among 129 cases (57.3％)with certain cytological diagnosis,15.1％ (34/225) were benign lesions,14.7％ (33/225) were tumors (benign or others) and 27.6％ (62/225) were malignant tumors.When atypical lesions were added into non-tumor lesions or tumor lesions,the sensitivity,specificity and accuracy of diagnosis were 87.3 ％,91.7％,88.2％,and 94.7％,72.2％,90.3％,respectively.Serum CA125≥14 kU/L (odds ratio (OR) =7.13,95％ confidence interval (CI) 2.02 to 25.22,P=0.002) and history of biliary disease (OR=3.85,95％CI 1.22 to 12.51,P=0.022) were two independent risk factors of pancreatic tumors.Conclusions Despite of a high percentage of uncertain cytological diagnosis,EUS-FNA still has high diagnostic value in SPL when combined with the new papanicolaou society of cytopathology terminology.Furthermore,serum CA125≥14 kU/L and history of biliary disease may help to diagnose pancreatic tumors.
