Features of chronic pancreatitis by endoscopic ultrasound influence the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration of small pancreatic lesions
Yusuke Kurita
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorCorresponding Author
Takamichi Kuwahara
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Corresponding: Takamichi Kuwahara and Kazuo Hara, Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. Emails: [email protected] (TK); [email protected] (KH)Search for more papers by this authorCorresponding Author
Kazuo Hara
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Corresponding: Takamichi Kuwahara and Kazuo Hara, Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. Emails: [email protected] (TK); [email protected] (KH)Search for more papers by this authorNobumasa Mizuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorNozomi Okuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorShimpei Matsumoto
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorMasahiro Obata
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorHiroki Koda
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorMasahiro Tajika
Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorYasuhiro Shimizu
Department of Surgery, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorAtsushi Nakajima
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorKensuke Kubota
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorYasumasa Niwa
Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorYusuke Kurita
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorCorresponding Author
Takamichi Kuwahara
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Corresponding: Takamichi Kuwahara and Kazuo Hara, Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. Emails: [email protected] (TK); [email protected] (KH)Search for more papers by this authorCorresponding Author
Kazuo Hara
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Corresponding: Takamichi Kuwahara and Kazuo Hara, Department of Gastroenterology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan. Emails: [email protected] (TK); [email protected] (KH)Search for more papers by this authorNobumasa Mizuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorNozomi Okuno
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorShimpei Matsumoto
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorMasahiro Obata
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorHiroki Koda
Department of Gastroenterology, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorMasahiro Tajika
Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorYasuhiro Shimizu
Department of Surgery, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorAtsushi Nakajima
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorKensuke Kubota
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Kanagawa, Japan
Search for more papers by this authorYasumasa Niwa
Department of Endoscopy, Aichi Cancer Center Hospital, Aichi, Japan
Search for more papers by this authorAbstract
Background and Aim
In chronic pancreatitis (CP) patients, diagnosis of small pancreatic lesions by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is challenging. Thus, the aim of the present study was to investigate whether CP influences the diagnostic ability of EUS-FNA for pancreatic lesions ≤10 mm.
Methods
One hundred and seventeen patients who underwent EUS-FNA for pancreatic lesions ≤10 mm in size were enrolled. Patients were classified into two groups based on features of CP observed by EUS (EUS-CP features) in accordance with the Rosemont classification. The CP group was defined as cases consistent with CP or suggestive of CP, and the non-CP group was defined as cases indeterminate for CP or normal. Factors influencing the diagnostic accuracy of EUS-FNA and CP status in pancreatic tumors were also investigated.
Results
Diagnostic ability of EUS-FNA (overall cases, non-CP vs CP) had sensitivity (80.4%, 96.7% vs 57.1%; P < 0.001), specificity (100%, 100% vs 100%; P > 0.05), and accuracy (91.5%, 98.6% vs 80.4%; P = 0.001). In multivariate analysis of factors influencing the accuracy of EUS-FNA, CP significantly lowered the accuracy (P = 0.048; odds ratio [OR] = 9.21). Among pancreatic cancer patients, the number of CP patients was significantly higher than the number of patients with benign lesions (P = 0.023). In multivariate analysis, lobularity without honeycombing was more frequently observed in cases of pancreatic cancer (P = 0.018; OR, 12.65).
Conclusion
Endoscopic ultrasound-guided FNA offers high accuracy for small pancreatic lesions ≤10 mm. However, in cases with CP, the diagnostic ability of EUS-FNA is significantly reduced.
Conflicts of Interest
Authors declare no conflicts of interest for this article.
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