Effect of Pancreatic Mass Size on Clinical Outcomes of Endoscopic Ultrasound-Guided Fine-Needle Aspiration

  • Ryo Sugiura
  • Masaki KuwataniEmail author
  • Koji Hirata
  • Itsuki Sano
  • Shin Kato
  • Kazumichi Kawakubo
  • Naoya Sakamoto
Original Article



Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has high diagnostic accuracy for pancreatic diseases. However, the effect of mass size on diagnostic accuracy has yet to be determined, especially for small pancreatic lesions. We aimed to determine the effect of pancreatic mass size on the diagnostic yield of EUS-FNA.


We searched the database in Hokkaido University Hospital between May 2008 and December 2016 and identified solid pancreatic lesions examined by EUS-FNA. All lesions were stratified into five groups based on mass sizes: groups A (< 10 mm), B (10–20 mm), C (20–30 mm), D (30–40 mm) and E (≥ 40 mm). The sensitivity, specificity, diagnostic accuracy and adverse event rate were retrospectively evaluated.


We analyzed a total of 788 solid pancreatic lesions in 761 patients. The patients included 440 males (57.8%) with a mean age of 65.7 years. The sensitivities in groups A (n = 36), B (n = 223), C (n = 304), D (n = 147) and E (n = 78) were 89.3%, 95.0%, 97.4%, 98.5% and 98.7%, respectively, and they significantly increased as the mass size increased (P < 0.01, chi-squared test for trend). The diagnostic accuracies were 91.7%, 96.4%, 97.7%, 98.6% and 98.7%, respectively, and they also significantly increased as the mass size increased (P = 0.03). Multivariate analysis showed that pancreatic mass size was associated with diagnostic accuracy. The adverse event rates were not significantly different among the five groups.


The sensitivities and diagnostic accuracies of EUS-FNA for solid pancreatic lesions are higher for lesions ≥ 10 mm in size, and they are strongly correlated with mass size.


Endoscopic ultrasonography Endoscopic ultrasonography fine-needle aspiration Pancreatic tumor 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Ryo Sugiura
    • 1
  • Masaki Kuwatani
    • 2
    Email author
  • Koji Hirata
    • 1
  • Itsuki Sano
    • 1
  • Shin Kato
    • 1
  • Kazumichi Kawakubo
    • 1
  • Naoya Sakamoto
    • 1
  1. 1.Department of Gastroenterology and HepatologyHokkaido University Faculty of Medicine and Graduate School of MedicineSapporoJapan
  2. 2.Division of EndoscopyHokkaido University HospitalSapporoJapan

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