Evaluation of endoscopic cytological diagnosis of unresectable pancreatic cancer prior to and after the introduction of endoscopic ultrasound‑guided fine-needle aspiration

Ushijima,Tomoyuki; Okabe,Yoshinobu; Ishida,Yusuke; Sugiyama,Gen; Sasaki,Yu; Kuraoka,Kei; Yasumoto,Makiko; Taira,Tomoki; Naito,Yoshiki; Nakayama,Masamichi; Tsuruta,Osamu; Sata,Michio

doi:10.3892/mco.2014.277

Evaluation of endoscopic cytological diagnosis of unresectable pancreatic cancer prior to and after the introduction of endoscopic ultrasound‑guided fine-needle aspiration

Authors:
- Tomoyuki Ushijima
- Yoshinobu Okabe
- Yusuke Ishida
- Gen Sugiyama
- Yu Sasaki
- Kei Kuraoka
- Makiko Yasumoto
- Tomoki Taira
- Yoshiki Naito
- Masamichi Nakayama
- Osamu Tsuruta
- Michio Sata
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Affiliations: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan, Department of Diagnostic Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan, Department of Pathology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
Published online on: April 14, 2014 https://doi.org/10.3892/mco.2014.277
Pages: 599-603

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Abstract

With the advances in the multidisciplinary treatment of pancreatic cancer (PC) over the last few years, it is crucial to obtain a histopathological diagnosis prior to treatment. Histopathological diagnosis for unresectable PC is currently performed with endoscopic retrograde cholangiopancreatography (ERCP) in combination with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). we retrospectively assessed the results of these two methods and investigated diagnostic performance according to the location of the lesion and the complications. This study was conducted on a series of 263 consecutive cases of unresectable PC diagnosed with endoscopic cytology. Up to 2006, ERCP-guided cytology (group A) was performed as the first choice for the diagnosis of PC. EUS-FNA was introduced in 2007 and became the first choice thereafter (group B), except in cases with obstructive jaundice, in which ERCP-guided cytology during endoscopic biliary stenting (EBS) remains the first choice. There were statistically significant differences in the overall cancer-positive rate between groups A and B (60.4 vs. 75.3%, P=0.01). the cancer-positive rate in the pancreatic body and tail was significantly higher in group B (59.5 vs. 83.3%, P=0.005), whereas there were no significant differences regarding cancer of the pancreatic head. The complication rate was 4.95% in group A and 3.09% in group B (P=0.448). The endoscopic cytology cancer-positive rate in unresectable PC cases was increased as a result of the introduction of EUS-FNA. In conclusion, we recommend performing EUS-FNA in combination with ERCP‑guided cytology in cases with a lesion in the pancreatic head that requires EBS.

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