BACKGROUND: The currently accepted paradigm is that the false-positive (FP) rate for EUS-guided fine-needle aspiration (EUS-FNA) cytologic analysis of a pancreatic lesion is less than 1%. OBJECTIVE: To assess the FP rate of EUS-FNA in patients who underwent surgical resection for presumed pancreatic cancer. DESIGN: Retrospective study. SETTING: Tertiary-care referral center. PATIENTS: This study involved 367 patients with solid pancreatic lesions in whom EUS-FNA cytology results were interpreted as positive or suspicious for malignancy, which resulted in subsequent surgical resection. INTERVENTION: Surgical resection. MAIN OUTCOME MEASUREMENTS: The FP diagnosis was defined as EUS-FNA cytology specimens being reported as "positive" or "suspicious for malignancy" but that were later proven to be benign on surgical pathology. RESULTS: The FP rate for EUS-FNA was 4 of 367 (1.1%) when only "positive" cytology findings were interpreted as malignant and 14 of 367 (3.8%) when both suspicious and positive cytology findings were interpreted as malignant. Among the 4 cases falsely interpreted as positive, 1 was falsely diagnosed cytologically as a neuroendocrine tumor and 3 as adenocarcinomas. All FP specimens showed chronic pancreatitis on surgical pathology. The incidence of discordance between cytology and surgical pathology did not change over time (2000-2006: 8/188 [4.3%] vs 2007-2010: 6/179 [3.4%]; P = .79). LIMITATIONS: Retrospective study at a single center. CONCLUSION: In a retrospective cohort trial, the FP rate for EUS-FNA of solid pancreatic lesions was 1.1%. Findings of the current study are in line with previous studies that have evaluated the FP cytology rates with EUS-FNA of solid lesions. FP cases transpired primarily as a result of cytologic misinterpretation in the setting of chronic pancreatitis.
BACKGROUND: The currently accepted paradigm is that the false-positive (FP) rate for EUS-guided fine-needle aspiration (EUS-FNA) cytologic analysis of a pancreatic lesion is less than 1%. OBJECTIVE: To assess the FP rate of EUS-FNA in patients who underwent surgical resection for presumed pancreatic cancer. DESIGN: Retrospective study. SETTING: Tertiary-care referral center. PATIENTS: This study involved 367 patients with solid pancreatic lesions in whom EUS-FNA cytology results were interpreted as positive or suspicious for malignancy, which resulted in subsequent surgical resection. INTERVENTION: Surgical resection. MAIN OUTCOME MEASUREMENTS: The FP diagnosis was defined as EUS-FNA cytology specimens being reported as "positive" or "suspicious for malignancy" but that were later proven to be benign on surgical pathology. RESULTS: The FP rate for EUS-FNA was 4 of 367 (1.1%) when only "positive" cytology findings were interpreted as malignant and 14 of 367 (3.8%) when both suspicious and positive cytology findings were interpreted as malignant. Among the 4 cases falsely interpreted as positive, 1 was falsely diagnosed cytologically as a neuroendocrine tumor and 3 as adenocarcinomas. All FP specimens showed chronic pancreatitis on surgical pathology. The incidence of discordance between cytology and surgical pathology did not change over time (2000-2006: 8/188 [4.3%] vs 2007-2010: 6/179 [3.4%]; P = .79). LIMITATIONS: Retrospective study at a single center. CONCLUSION: In a retrospective cohort trial, the FP rate for EUS-FNA of solid pancreatic lesions was 1.1%. Findings of the current study are in line with previous studies that have evaluated the FP cytology rates with EUS-FNA of solid lesions. FP cases transpired primarily as a result of cytologic misinterpretation in the setting of chronic pancreatitis.
Authors: Sachin Wani; Michael B Wallace; Jonathan Cohen; Irving M Pike; Douglas G Adler; Michael L Kochman; John G Lieb; Walter G Park; Maged K Rizk; Mandeep S Sawhney; Nicholas J Shaheen; Jeffrey L Tokar Journal: Am J Gastroenterol Date: 2014-12-02 Impact factor: 10.864
Authors: Leticia Perondi Luz; Mohammad Ali Al-Haddad; Michael Sai Lai Sey; John M DeWitt Journal: World J Gastroenterol Date: 2014-06-28 Impact factor: 5.742
Authors: Vicente Valero; Tyler J Saunders; Jin He; Matthew J Weiss; John L Cameron; Avani Dholakia; Aaron T Wild; Eun Ji Shin; Mouen A Khashab; Anne Marie O'Broin-Lennon; Syed Z Ali; Daniel Laheru; Ralph H Hruban; Christine A Iacobuzio-Donahue; Joseph M Herman; Christopher L Wolfgang Journal: Ann Surg Date: 2016-01 Impact factor: 12.969
Authors: Christian Jenssen; Maria Victoria Alvarez-Sánchez; Bertrand Napoléon; Siegbert Faiss Journal: World J Gastroenterol Date: 2012-09-14 Impact factor: 5.742