Yield of EUS-FNA of Pancreatic Masses in the Presence or Absence of Chronic Pancreatitis

Varadarajulu, Shyam; Tamhane, Ashutosh; Eloubeidi, Mohamad A.

doi:10.1016/s0016-5107(05)01530-0

Cited by 17 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In this study, routine cytology had sensitivity of 41%, which is much lower than previously reported (usual range 70% to 90% [2][3][4][5][6][7][8][9][10][11][12][13][14] ). This was due to higher prevalence of indeterminate cytology at 46%, versus 4% to 26% reported in other studies [2][3][4][5][6][7][8][9][10][11][12][13][14] . The discrepancy is possibly due to instances of differing cytologic criteria having been applied to different patient populations.…”

Section: Discussioncontrasting

confidence: 71%

“…The overall 5-year survival rate is less than 5%, although early detection and curative resection can improve the survival rate to 20% [1] . Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has high specificity for malignancy in a solid pancreatic lesion, but sensitivity varies from 70% to 90% [2][3][4][5][6][7][8][9][10][11][12][13][14] . This is due to suboptimal sampling and cases of indeterminate cytology.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Jahng

Reicher²,

Chung³

et al. 2010

WJGE

View full text Add to dashboard Cite

AIM:To investigate whether tumor marker staining can improve the sensitivity of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) to diagnose pancreatic malignancy. METHODS:Patients who underwent EUS-FNA were retrospectively identified. Each EUS-FNA specimen was evaluated by routine cytology and stained for tumor markers p53, Ki-67, carcinoembryonic antigen (CEA) and CA19-9. Sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (PLR and NLR) were calculated in order to evaluate the performance of each test to detect malignancy. RESULTS:Sixty-one specimens had complete sets of stains, yielding 49 and 12 specimens from pancreatic adenocarcinomas and benign pancreatic lesions due to pancreatitis, respectively. Cytology alone had sensitivity and specificity of 41% and 100% to detect malignancy, respectively. In 46% of the specimens, routine cytology alone was deemed indeterminate. The addition of either p53 or Ki-67 increased the sensitivity to 51% and 53%, respectively, with perfect specificity, PPV and PLR (100%, 100% and infinite). Both stains in combination increased the sensitivity to 57%. While additional staining with CEA and CA19-9 further increased the sensitivity to 86%, the specificity, PPV and PLR were significantly reduced (at minimum 42%, 84% and 1, respectively). Markers in all combinations performed poorly as a negative test (NPV 26% to 47%, and NLR 0.27 and 0.70). CONCLUSION: Immunohistochemical staining for p53and Ki-67 can improve the sensitivity of EUS-FNA to diagnose pancreatic adenocarcinoma.

show abstract

Section: Discussioncontrasting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Jahng

Reicher²,

Chung³

et al. 2010

WJGE

View full text Add to dashboard Cite

show abstract

“…Ancak yapılan çalışmaların birçoğunda tek başına EUS bulguları, kronik pankreatit varlığında psödotümoral kitle ve kanser ayırımının yapılmasında yetersiz kalmıştır 14 . Pankreas parankimi normal olan olgularda EUS ile ince iğne aspirasyon biyopsisi (EUS-İİAB) ile malign olan ve olmayan pankreas lezyonlarının ayrımında sensitivite %75 ile 90 ve spesifite %90 ile 95 arasın-da değişmekte iken bu oran kronik pankreatitli olgularda %33 ile 75 arasında bulunmuştur 15 .…”

Section: Sonuçunclassified

Malignant Appearance of Pancreatic Benign Lesion: Focal Chronic Pancreatitis

Yağmurkaya¹,

Toka²,

Eminler³

et al. 2016

Sakarya Med J

View full text Add to dashboard Cite

Kronik pankreatit ve pankreas kanseri benzer klinik ve laboratuar bulguları ile zaman zaman birbirinden ayrımı oldukça zor olabilen iki ayrı pankreas patolojisidir. Ultrasonografi (USG), Bilgisayarlı Tomografi (BT), Manyetik Rezonans Görüntümele (MRI) gibi klasik radyolojik yöntemlerin yetersiz kaldığı durumlarda Fuorodeoksiglukoz-Pozitron Emisyon Tomografisi (FDG-PET), Endoskopik Ultrasonografi (EUS) ve EUS eşliğinde İnce İğne Aspirasyon Biyopsisi ayırıcı tanıda yararlı olabilmektedir. Bu yazıda pankreas başında inflamasyona sekonder genişleme ile karakterize, pankreas kanseri ile karışan bir fokal pankreatit olgusunu sunmaktayız.

show abstract

“…Furthermore, in addition to differentiation between benign and malignant lesions, EUS-FNA can also establish the final diagnosis in many cases (33). However, it is important to point out that the sensitivity of EUS-FNA for malignancy in parenchymal masses with features of CP is inferior compared to when the surrounding parenchyma is normal (19,(35)(36)(37)(38)(39). Fritscher-Ravens et al (19) found that sensitivity of EUS-FNA in patients with a focal pancreatic lesion without chronic pancreatitis was 89%, while it was only 54% in patients with chronic pancreatitis.…”

Section: Introductionmentioning

confidence: 99%

“…Fritscher-Ravens et al (19) found that sensitivity of EUS-FNA in patients with a focal pancreatic lesion without chronic pancreatitis was 89%, while it was only 54% in patients with chronic pancreatitis. Varadarajulu et al (36) investigated 282 patients with pancreatic solid tumors. Sensitivity of EUS-FNA for malignancy was lower in the group of patients with concurrent chronic pancreatitis compared to those without (73.9 vs. 91.3%; p = 0.02).…”

Section: Introductionmentioning

confidence: 99%

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

Iglesias‐García

Lindkvist

Lariño‐Noia³

et al. 2012

Rev. esp. enferm. dig.

View full text Add to dashboard Cite

Differential diagnosis of solid pancreatic lesions remains as an important clinical challenge, mainly for the differentiation between mass forming chronic pancreatitis, autoimmune pancreatitis and pancreatic adenocarcinoma. Endoscopic ultrasound (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) can all provide valuable and complementary information in this setting. Among them, EUS has the unique ability to obtain specimens for histopathological diagnosis and can therefore play a crucial role in the evaluation patients with inconclusive findings on initial examinations. Nowadays, new developed techniques associated to EUS, like elastography and contrast enhancement, have shown promising results for the differential diagnosis of these pancreatic lesions.Key words: Endoscopic ultrasound. CT scan. MRI. Pancreatic tumors. INTRODUCTIONDifferential diagnosis of solid pancreatic masses remains a challenge, despite recent advances in different diagnostic procedures. In this article, the role of endoscopic ultrasound (EUS) including EUS-guided FNA, elastography and contrast enhancement will be reviewed in relation to computer tomography (CT), magnetic resonance tomography (MRI) and magnetic resonance cholangiopancreatography (MRCP). Differential diagnosis between malignant lesions and mass-forming chronic pancreatitis or focal autoimmune pancreatitis will be discussed. Tumor staging and evaluation of resectability of these pancreatic lesions will not be evaluated. Other imaging techniques, like PET-scan or octreoscan will not be analyze, because their usefulness in this context is unclear.Differential diagnosis between malignant pancreatic lesions (pancreatic cancer, pancreatic metastasis) and massforming chronic pancreatitis CT scan is the most widely spread imaging modality for evaluation of pancreatic solid masses and considered as the most comprehensive tool for diagnosis and surgical staging of pancreatic malignancies (1). CT technology has significantly advanced over the last years, multidetector helical CT scan allows for very thin sliced cuts, providing a higher image resolution and faster image acquisition (Fig. 1) Vol. 104. N.° 6, pp. 315-321, 2012 Disclosures: Dr. Julio Iglesias-García is international advisor of Cook-Medical. Dr. J. Enrique Domínguez-Muñoz is international advisor of Pentax Medical Company.Received: 27-03-201227-03- Accepted: 20-04-2012 Correspondence: Julio Iglesias-García. Department of Gastroenterology.

show abstract

Yield of EUS-FNA of Pancreatic Masses in the Presence or Absence of Chronic Pancreatitis

Cited by 17 publications

References 0 publications

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Staining for p53 and Ki-67 increases the sensitivity of EUS-FNA to detect pancreatic malignancy

Malignant Appearance of Pancreatic Benign Lesion: Focal Chronic Pancreatitis

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

Contact Info

Product

Resources

About