J C Ardengh1, G A de Paulo, A P Ferrari. 1. Endoscopy Unit, Division of Gastroenterology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
Abstract
BACKGROUND: The size of a pancreatic carcinoma determines prognosis and resection. The aim of this study was to review our clinical experience with endoscopic ultrasound (EUS) in diagnosing and staging pancreatic tumours <3.0 in diameter. METHODS: From February 1997 to October 2000 medical records and results of abdominal ultrasound (US), spiral computed tomography (CT) and EUS with fine-needle aspiration biopsy (FNA) were reviewed in 17 patients operated for histologically proven pancreatic adenocarcinoma measuring <or= 3.0 cm in diameter. The mean age of the patients was 64 years (range 42-76 years). RESULTS: US identified a pancreatic lesion in 11/17 (65%) patients. Spiral CT showed a total of 16/17 (94%) patients with a lesion. EUS identified pancreatic tumour in all patients (100%), and tissue was obtained from 15/17 patients (88%). Mean tumour size was 2.5 cm (range 0.8-3.0 cm). EUS accuracy in evaluating the portal vessels was 78%, superior mesenteric artery 100%, tumour stage (T) 88%, isolated node stage (N) 65% and combined TN staging was 53%. Regarding resectability, EUS sensitivity was 88%, specificity 89%, negative predictive value 89%, positive predictive value 88% and accuracy 88%. Besides cytological material, EUS-FNA histological diagnosis was possible in 12/17 patients (71%). There was only one case of mild post-procedure acute pancreatitis. CONCLUSION: EUS-FNA is safe and has high diagnostic (100%) and local staging (88%) accuracy in pancreatic cancers <3.0 cm in diameter.
BACKGROUND: The size of a pancreatic carcinoma determines prognosis and resection. The aim of this study was to review our clinical experience with endoscopic ultrasound (EUS) in diagnosing and staging pancreatic tumours <3.0 in diameter. METHODS: From February 1997 to October 2000 medical records and results of abdominal ultrasound (US), spiral computed tomography (CT) and EUS with fine-needle aspiration biopsy (FNA) were reviewed in 17 patients operated for histologically proven pancreatic adenocarcinoma measuring <or= 3.0 cm in diameter. The mean age of the patients was 64 years (range 42-76 years). RESULTS: US identified a pancreatic lesion in 11/17 (65%) patients. Spiral CT showed a total of 16/17 (94%) patients with a lesion. EUS identified pancreatic tumour in all patients (100%), and tissue was obtained from 15/17 patients (88%). Mean tumour size was 2.5 cm (range 0.8-3.0 cm). EUS accuracy in evaluating the portal vessels was 78%, superior mesenteric artery 100%, tumour stage (T) 88%, isolated node stage (N) 65% and combined TN staging was 53%. Regarding resectability, EUS sensitivity was 88%, specificity 89%, negative predictive value 89%, positive predictive value 88% and accuracy 88%. Besides cytological material, EUS-FNA histological diagnosis was possible in 12/17 patients (71%). There was only one case of mild post-procedure acute pancreatitis. CONCLUSION: EUS-FNA is safe and has high diagnostic (100%) and local staging (88%) accuracy in pancreatic cancers <3.0 cm in diameter.
Authors: T Rösch; H J Dittler; K Strobel; A Meining; V Schusdziarra; R Lorenz; H D Allescher; A M Kassem; P Gerhardt; J R Siewert; H Höfler; M Classen Journal: Gastrointest Endosc Date: 2000-10 Impact factor: 9.427
Authors: T Rösch; R Lorenz; C Braig; S Feuerbach; J R Siewert; V Schusdziarra; M Classen Journal: Gastrointest Endosc Date: 1991 May-Jun Impact factor: 9.427
Authors: P Legmann; O Vignaux; B Dousset; A J Baraza; L Palazzo; I Dumontier; J Coste; A Louvel; G Roseau; D Couturier; A Bonnin Journal: AJR Am J Roentgenol Date: 1998-05 Impact factor: 3.959
Authors: A Nakaizumi; H Uehara; H Iishi; M Tatsuta; T Kitamura; C Kuroda; H Ohigashi; O Ishikawa; S Okuda Journal: Dig Dis Sci Date: 1995-03 Impact factor: 3.199
Authors: José Celso Ardengh; Ricardo H Bammann; Matheus de Giovani; Filadelfio Venco; Artur A Parada Journal: Clinics (Sao Paulo) Date: 2011 Impact factor: 2.365