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Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA.

Abstract：

BACKGROUND:Despite advances in diagnostic imaging techniques, the differentiation between pancreatic cancer and focal pancreatitis remains difficult. This study evaluated the effectiveness of EUS-guided FNA in the differential diagnosis between pancreatic cancer and focal pancreatitis, with particular reference to detection of the K-ras point mutation. METHODS:The study included 62 consecutive patients with pancreatic ductal cancer and 15 patients with focal pancreatitis demonstrated as a pancreatic mass lesion by EUS. RESULTS:Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of cytopathologic diagnosis were 82%, 100%, 86%, 100%, and 58%, respectively. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of histopathologic diagnosis were 44%, 100%, 55%, 100%, and 32%, respectively. The K-ras point mutation was found in 74% of pancreatic cancers and 0% of focal pancreatitis lesions. No complication of EUS-guided FNA was observed. CONCLUSIONS:EUS-guided FNA is useful for the differential diagnosis of pancreatic mass lesions caused by pancreatic cancer and focal pancreatitis. Analysis for the K-ras point mutation in specimens obtained by EUS-guided FNA may enhance diagnostic accuracy in indeterminate cases.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Takahashi K,Yamao K,Okubo K,Sawaki A,Mizuno N,Ashida R,Koshikawa T,Ueyama Y,Kasugai K,Hase S,Kakumu S

doi

10.1016/s0016-5107(04)02224-2

keywords:

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

76-9

issue

1

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(04)02224-2

journal_volume

61

pub_type

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