Diagnostic Yield of Endoscopic Ultrasonography–Guided Fine-Needle Aspiration (Eus-Fna) for Solid Pancreatic Masses

Abstract

Background:

Endoscopic ultrasound-Fine-needle aspiration (EUS)-FNA is one of the most sensitive and accurate modalities, for detecting and staging pancreatic masses and for obtaining a histological diagnosis. Our studies aim to assess the diagnostic yield of EUS-FNA in solid pancreatic masses.

METHODS: Forty-five patients with solid pancreatic masses on imagery were included out of 230 EUS performed between September 2018 and January 2020. All the patients, underwent EUS-FNA using 19G or 22G needles. All the masses were divided into 2 groups based on mass size: group A (< 30 mm) and group B (> 30mm). Sensitivity, negative predictive value (NPV), and diagnostic accuracy were respectively evaluated. The specificity and positive predictive value were 100% in both groups. Statistical analysis was performed using SPSS, and the significance level was set at p <0.05.

RESULTS: Overall, sensitivity and diagnostic accuracy were significantly higher in group B (80,7% vs 46% (p=0,01), and 89,2% vs 58,8%(p=0,02)). Only the sensitivity was significantly higher with 19 G (p=0,02) in group A. In group B, the sensitivity and diagnostic accuracy were higher with 22G (71% vs 50% (p=0,6), 93,3% vs 69,5% (p=0,5), despite more passes were performed with 22G (2,55 ± 0,59 vs 1,96 ± 0,56 p = 0.001). The multivariate analysis showed that the risk of getting a negative EUS-FNA is 6,46 times higher in group A (p=0,009).

CONCLUSION: The diagnostic yield of EUS-FNA is correlated at the pancreatic mass size and the risk to get a negative EUS-FNA is 6,46 times higher for masses <30mm.

KEYWORDS: EUS-FNA, Solid mass, Needle size, Puncture route, Lesion size.