Endosonographically Guided Fine Needle Aspiration (Eus-Fna) Of Solid Pancreatic Mass Lesions: Comparison Of Histological And Cytological Analyses

Aim of the Study: To compare the diagnostic accuracy of histologicy and cytologicy from endosonographically guided fine needle aspiration specimens in patients with solid pancreatic tumours. Assessment of potential diagnostic gain by histology over cytology. Patients and Methods: 104 consecutive EUS-FNA were analysed retrospectively which were performed in two centers using the same methodological approach by two experienced examiners. EUS (Olympus GF UCT 140/160P; Pentax EG 3830 UT) and FNA (22-G-FNA; Wilson Cook, Mediglobe) were performed in standarde fashion; solid cylindric material gained by introducing the stylet into the needle was sent for histology, whereas the remaining fluid material was smeared for cytologic analysis. Results: Material suitable for cytological analysis was obtained in 96,1%, whereas this rate was only 74,6% for histology. Final diagnosis including independent tissue confirmation or follow-up was adenocarcinoma n = 54; neuroendocrine tumour n = 5; other malignant tumour n = 8, inflammatory lesions n = 37. Sensitivity and specificity for the diagnosis of malignancy were 74,6% and 94,7% (cytology) and 58,2% and 89,2% (histology). In the subgroup of adequate specimens sensitivities and specificities were similar (cytology 78,1% and 100%, histology 69,6% and 97,5%). The combination of both methods increased sensitivity to 85.2% (specificity 97,2%). A specific tumor tissue characterization was possible in 20-41% by cytology and 25-44% by histology depending on tumor type. Summary/Conclusions: Due to a higher percentage of insufficient material, sensitivity and specificity of EUS-FNA-histology in pancreatic tumors were lower than those of EUS-FNA-cytology. The combination of both techniques improved the overall results of EUS-FNA.