Endoscopic ultrasound with fine needle aspiration is useful in pancreatic cysts smaller than 3 cm.
BMC Gastroenterol
; 20(1): 413, 2020 Dec 09.
Article
en En
| MEDLINE
| ID: mdl-33297971
ABSTRACT
BACKGROUND:
In current guidelines, endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is recommended in pancreatic cystic lesions (PCLs) with worrisome features (size ≥ 3 cm, mural nodule, or Wirsung dilation).OBJECTIVE:
To evaluate the diagnostic ability and assess the accuracy of EUS-FNA in PCLs smaller than 3 cm.METHODS:
Retrospective study of PCLs < 3 cm (2007-2016) undergoing EUS-FNA. Clinical, EUS and pancreatic cystic fluid (PCF) data were prospectively registered. Performance of EUS-FNA with PCF analysis for the detection of malignancy and accuracy in surgical cohort were analyzed.RESULTS:
We evaluated 115 patients with PCLs < 3 cm who underwent EUS-FNA. 19 patients underwent surgery, 7 had malignant, 8 pre-malignant, and the remaining 4 benign lesions. Mass/mural nodule was present in 27% of the cysts, CEA level was higher than 192 ng/mL in 39.4% of patients, and only 35% of cytologic samples were informative. Nevertheless, additional FNA for PCF analysis improved the diagnostic performance of EUS imaging-AUC = 0.80 versus AUC = 60.CONCLUSION:
EUS-FNA has good accuracy in PCLs < 3 cm. It confirmed malignancy even in lesions without worrisome features (nodule/mass), with two in every five resections showing high-risk/malignant lesions. EUS-FNA was also useful to diagnose benign cysts, possibly allowing surveillance to be stopped in one in every five patients.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Quiste Pancreático
/
Neoplasias Pancreáticas
Tipo de estudio:
Guideline
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2020
Tipo del documento:
Article