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Medline ® Abstract for Reference 31

of 'Endoscopic ultrasound in the staging of exocrine pancreatic cancer'

Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses.
Harewood GC, Wiersema MJ
Am J Gastroenterol. 2002;97(6):1386.
OBJECTIVES: Diagnosis of pancreatic tumors can be problematic. This study aimed to determine the performance of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS FNA) in pancreatic malignancy when prior biopsies performed by CT guidance or ERCP were negative.
METHODS: A total of 185 patients with known or suspected pancreatic masses were prospectively evaluated with EUS FNA. Before EUS FNA, all patients were evaluated with abdominal CT (61 with CT-guided biopsy) and 91 with ERCP (41 had brushings or biopsy).
RESULTS: EUS had greater sensitivity than CT in detecting a mass (99% vs 57%, p<0.0001). In 58 patients with negative CT-guided biopsies, EUS FNA had 90% sensitivity for malignancy, 50% specificity for benign disease and 84% accuracy. Similarly, in 36 patients with negative ERCP tissue sampling, results for EUS FNA were 94%, 67% and 92%, respectively. Complications were mild and infrequent (0.5%).
CONCLUSION: EUS FNA of pancreatic masses safely and accurately diagnoses pancreatic malignancy when prior biopsy techniques have been unsuccessful.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.