Endoscopic Ultrasound-guided Fine Needle Aspiration:Diagnostic Value Of Pathological Methods In Solid Pancreatic Tumors

Objective: To investigate the diagnostic value of different pathological methods of Endoscopic Ultrasound-guided fine needle aspiration in solid pancreatic tumors.Methods: We retrospectively analyzed patients who were diagnosed of pancreatic solid mass from January 2014 to December 2018,and were performed EUS-FNA in the endoscopy center of Shengjing Hospital affiliated to China Medical University.All patients were subjected to histological or cytological examination following EUS-FNA.Procedures of EUS-FNA and pathology,supported by rapid on-site pathology(ROSE),were completed by endoscopists with more than 10 years of operation experience and an expert pathologist.Diagnostic gold criteria is surgical pathology or at least half a year clinical follow-up.The consistencies between results of EUS-FNA pathology and gold criteria was recorded.Independent influencing factors of EUS-FNA diagnostic efficacy were determined by Logistic Multivariate analysis method.Results of accuracy,sensitivity,specificity,positive predictive value and negative predictive value of different pathology were calculated and compared.Results: A total of 114 patients(61 male and 53 female)were included in the study with an average age of 56.8±11.37 years.There were 67 cases in the head of the pancreas,8 in the neck of the pancreas,31 in the body-tail,and the other 8 cases were diffuse lesions.Except diffuse lesions,the maximum diameter ranged 12-87 mm,with an average of 34.3±14.60 mm.Confirmed by surgical pathology or follow-up observation,there were 76 cases of pancreatic cancer and 38 cases of inflammatory pseudotumor.All the EUS-FNA operations were successful with a total accuracy of89.47%.A total of 65 patients were diagnosed in histological method and 114 cases in cytological method.Multivariate analysis showed the effects of sex,age,type of puncture needle,maximum diameter of the lesion,and location of the lesion on the diagnostic results were not statistically significant.Results of accuracy,sensitivity,specificity,positive predictive value,negative predictive value and Jordon index of histopathology were 78.46%、65.85%、100%、100%、63.16%、65.85%.Results of accuracy,sensitivity,specificity,positive predictive value,negative predictive valueand Jordon index of cytology were89.47%、85.53%、97.37%、98.48%、77.08%、82.90%.The sensitivity of cytological diagnosis was higher than that of histology,with statistical significant(P <0.05).Conclusion: EUS-FNA is consistent with the diagnosis of solid pancreatic tumors.Cytology has a significantly higher sensitivity than histological pathology for EUS-FNA diagnosis of solid pancreatic tumors.