TY - JOUR
T1 - Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA
AU - Takahashi, Kuniyuki
AU - Yamao, Kenji
AU - Okubo, Kenji
AU - Sawaki, Akira
AU - Mizuno, Nobumasa
AU - Ashida, Reiko
AU - Koshikawa, Takashi
AU - Ueyama, Yuji
AU - Kasugai, Kunio
AU - Hase, Satoshi
AU - Kakumu, Shinichi
PY - 2005/1
Y1 - 2005/1
N2 - Despite advances in diagnostic imaging techniques, the differentiation between pancreatic cancer and focal pancreatitis remains difficult. This study evaluated the effectiveness of EUS-guided FNA in the differential diagnosis between pancreatic cancer and focal pancreatitis, with particular reference to detection of the K-ras point mutation. The study included 62 consecutive patients with pancreatic ductal cancer and 15 patients with focal pancreatitis demonstrated as a pancreatic mass lesion by EUS. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of cytopathologic diagnosis were 82%, 100%, 86%, 100%, and 58%, respectively. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of histopathologic diagnosis were 44%, 100%, 55%, 100%, and 32%, respectively. The K-ras point mutation was found in 74% of pancreatic cancers and 0% of focal pancreatitis lesions. No complication of EUS-guided FNA was observed. EUS-guided FNA is useful for the differential diagnosis of pancreatic mass lesions caused by pancreatic cancer and focal pancreatitis. Analysis for the K-ras point mutation in specimens obtained by EUS-guided FNA may enhance diagnostic accuracy in indeterminate cases.
AB - Despite advances in diagnostic imaging techniques, the differentiation between pancreatic cancer and focal pancreatitis remains difficult. This study evaluated the effectiveness of EUS-guided FNA in the differential diagnosis between pancreatic cancer and focal pancreatitis, with particular reference to detection of the K-ras point mutation. The study included 62 consecutive patients with pancreatic ductal cancer and 15 patients with focal pancreatitis demonstrated as a pancreatic mass lesion by EUS. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of cytopathologic diagnosis were 82%, 100%, 86%, 100%, and 58%, respectively. Sensitivity, specificity, overall accuracy, positive predictive value, and negative predictive value of histopathologic diagnosis were 44%, 100%, 55%, 100%, and 32%, respectively. The K-ras point mutation was found in 74% of pancreatic cancers and 0% of focal pancreatitis lesions. No complication of EUS-guided FNA was observed. EUS-guided FNA is useful for the differential diagnosis of pancreatic mass lesions caused by pancreatic cancer and focal pancreatitis. Analysis for the K-ras point mutation in specimens obtained by EUS-guided FNA may enhance diagnostic accuracy in indeterminate cases.
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UR - http://www.scopus.com/inward/citedby.url?scp=19944431069&partnerID=8YFLogxK
U2 - 10.1016/S0016-5107(04)02224-2
DO - 10.1016/S0016-5107(04)02224-2
M3 - Article
C2 - 15672060
AN - SCOPUS:19944431069
SN - 0016-5107
VL - 61
SP - 76
EP - 79
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 1
ER -
