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Endosc Int Open 2016; 04(04): E434-E438
DOI: 10.1055/s-0035-1569969
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Performance characteristic of endoscopic ultrasound-guided fine needle aspiration is unaffected by pancreatic mass size

Jayapal Ramesh
1   Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
,
Hwasoon Kim
2   Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA
,
Kartika Reddy
1   Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA
,
Isam-Eldin A. Eltoum
3   Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
› Author Affiliations
Further Information

Publication History

submitted 17 August 2015

accepted after revision 25 January 2016

Publication Date:
30 March 2016 (online)

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Background and study aims: Despite a well-established tool for diagnosis of pancreatic masses, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) studies have shown suboptimal diagnostic performance at divergent mass sizes. Since the impact of gold standard follow-up and presence of on-site evaluation on this observation is unknown, we aimed to study the performance characteristics of EUS-FNA under these strict conditions.

Patients and methods: EUS-FNA results from pancreatic mass lesions performed between July 2000 and March 2013 were evaluated. All patients with histological follow-up were then stratified into four groups: Group A ( ≤ 10 mm), Group B (11 – 20 mm), Group C (21 – 40 mm), and Group D (> 40 mm). Sensitivity and diagnostic accuracy were calculated for each group and compared.

Results: A total of 612 /3832 (16 %) patients with pancreatic masses who underwent EUS-FNA had histology confirmation. Of these, 81 were excluded due to unavailable lesion size, while the rest formed the study cohort. Mean age (SD) was 65.8 years (9.3) with 51.2 % female. The mean number of passes for the entire cohort was 2.9 (SD 1.9; range 1 – 12); patients in group D had a significantly higher number of passes for on-site diagnosis (P = 0.0124). There was no significant difference between the groups for sensitivity (P = 0.1134) or diagnostic accuracy (P = 0.2111). Proportional trend analysis revealed no significant correlation between size and sensitivity (P = 0.6192). The size of lesion measured by EUS was not associated with sensitivity or specificity after adjusting for age, sex, and pancreatic location.

Conclusion: In the presence of rapid on-site cytopathology and when final histology is taken as the gold standard, pancreatic mass size does not affect the performance characteristics of EUS-FNA.

 

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