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Fine needle aspiration of pancreatic cysts: Use of ancillary studies and difficulty in identifying surgical candidates.
- Source :
-
Acta cytologica [Acta Cytol] 2006 Nov-Dec; Vol. 50 (6), pp. 647-55. - Publication Year :
- 2006
-
Abstract
- Objective: To evaluate ancillary biochemical testing after pancreatic cyst fine needle aspiration (FNA) in the clinical setting.<br />Study Design: Findings from 110 pancreatic guided FNA were reviewed cysts evaluated by image- and correlated with histology, clinical follow-up and biochemical analysis of cyst fluid and serum. Adequate followup was available for 95.<br />Results: In terms of identifying cysts requiring surgery, FNA showed 55.3% sensitivity, 95% specificity, 92.9% positive predictive value (PPV) and 64.4% negative predictive value (NPV). FNA showed only nonspecific cyst contents in 51% of cases, but 40% of those patients proved to be surgical candidates at follow-up. Overall, patients with lesions requiring surgery were younger (p = 0.14), more often presented with pain (p = 0.006), had larger cysts (p = 0.05) and less often had a history of chronic pancreatitis (p = 0.12). Among cases in which FNA showed only nonspecific cyst contents, patients with lesions requiring surgery were more often female (p = 0.08), were younger (p = 0.10), had larger cysts (p = 0.06) and had pain at presentation (p = 0.02). Differences in fluid and serum analytes were not statistically significant.<br />Conclusion: FNA of pancreatic cysts shows high specificity but poor sensitivity, even with cyst fluid and serum biochemical analysis. FNA of cysts requiring surgery often yielded nonspecific cyst cytology and causing a misinterpretation as pseudocysts. Ancillary biochemical analysis of cyst fluid remains problematic in the clinical setting.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Biopsy, Fine-Needle
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Pancreatic Cyst surgery
Pancreatic Neoplasms surgery
Sensitivity and Specificity
Pancreas pathology
Pancreatic Cyst pathology
Pancreatic Neoplasms pathology
Pathology, Surgical methods
Subjects
Details
- Language :
- English
- ISSN :
- 0001-5547
- Volume :
- 50
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Acta cytologica
- Publication Type :
- Academic Journal
- Accession number :
- 17152277
- Full Text :
- https://doi.org/10.1159/000326035