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Digestive Diseases and Sciences

, Volume 58, Issue 6, pp 1751–1757 | Cite as

Factors Determining Diagnostic Yield of Endoscopic Ultrasound Guided Fine-Needle Aspiration for Pancreatic Cystic Lesions: A Multicentre Asian Study

  • Lee Guan Lim
  • Sandeep Lakhtakia
  • Tiing Leong Ang
  • Charles K. F. Vu
  • Frederick Dy
  • Vui Heng Chong
  • Christopher J. L. Khor
  • Wee Chian Lim
  • Bhavesh Kishor Doshi
  • Shyam Varadarajulu
  • Kenjiro Yasuda
  • Jennie Y. Y. Wong
  • Yiong Huak Chan
  • Min En Nga
  • Khek Yu Ho
  • The Asian EUS Consortium
Original Article

Abstract

Background and Aim

The purpose of this study was to determine (1) the diagnostic yield for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in patients with pancreatic cystic lesions, (2) additional value of EUS-FNA over EUS alone in the diagnosis of pancreatic cysts, and (3) diagnostic sensitivity and specificity of EUS and EUS-FNA in the subset of patients where histopathology of surgical specimens were available.

Methods

All patients who underwent EUS examination for the evaluation of pancreatic cystic lesions in six Asian centres were included in the study.

Results

Of 298 patients with pancreatic cysts who underwent EUS, 132 (44.3 %) underwent FNA. In the entire cohort, pseudocysts and intraductal papillary mucinous neoplasm (IPMN) were the predominant cystic lesions. The cytologic yield of EUS-FNA was 47 %. On univariate analysis, factors associated with higher cytologic yield included vascular involvement on EUS, presence of solid cystic component, and increased number of needle passes during EUS-FNA. On multivariate analysis, presence of solid cystic components and increased number of needle passes during EUS-FNA were associated with higher diagnostic yield of EUS-FNA. For pancreatic cysts with a solid component, the diagnostic yield of EUS-FNA increased significantly from 44 % with one pass to 78 % with more than one pass (p = 0.016). In the absence of a solid component, the diagnostic yield was 29 % with one pass and was not significantly different from the diagnostic yield of 50 % with more than one pass, p = 0.081.

Conclusion

The cytologic yield of EUS-FNA was 47 %. When a solid component was present in the cyst, doing more than one pass during EUS-FNA increased its diagnostic yield.

Keywords

Pancreatic cysts Endoscopic ultrasound Fine-needle aspiration Diagnostic yield 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Lee Guan Lim
    • 1
  • Sandeep Lakhtakia
    • 2
  • Tiing Leong Ang
    • 3
  • Charles K. F. Vu
    • 4
  • Frederick Dy
    • 5
  • Vui Heng Chong
    • 6
  • Christopher J. L. Khor
    • 1
  • Wee Chian Lim
    • 4
  • Bhavesh Kishor Doshi
    • 1
  • Shyam Varadarajulu
    • 7
  • Kenjiro Yasuda
    • 8
  • Jennie Y. Y. Wong
    • 9
  • Yiong Huak Chan
    • 10
  • Min En Nga
    • 11
  • Khek Yu Ho
    • 1
    • 9
  • The Asian EUS Consortium
  1. 1.Department of Gastroenterology and HepatologyNational University Health SystemSingaporeSingapore
  2. 2.Asian Institute of GastroenterologyHyderabadIndia
  3. 3.Department of Gastroenterology and HepatologyChangi General HospitalSingaporeSingapore
  4. 4.Department of Gastroenterology and HepatologyTan Tock Seng HospitalSingaporeSingapore
  5. 5.University Santo Tomas HospitalManilaPhilippines
  6. 6.Department of MedicineRIPAS HospitalBrunei DarussalamBrunei
  7. 7.Basil I. Hirschowitz Endoscopic Center of ExcellenceUniversity of Alabama at Birmingham School of MedicineBirminghamUSA
  8. 8.Department of GastroenterologyKyoto Second Red Cross HospitalKyotoJapan
  9. 9.Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  10. 10.Biostatistics UnitNational University Health SystemSingaporeSingapore
  11. 11.Department of PathologyNational University Health SystemSingaporeSingapore

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