Optimal indication of endoscopic retrograde pancreatography-based cytology in the preoperative pathological diagnosis of pancreatic ductal adenocarcinoma

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is extremely useful for pathological diagnosis of pancreatic ductal adenocarcinoma (PDAC); however, puncturing is difficult in some cases, and there is a risk of needle tract seeding. This study evaluated the indications for endoscopic re...

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Published in:Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2022-04, Vol.22 (3), p.414-420
Main Authors: Kawamura, Ryota, Ishii, Yasutaka, Serikawa, Masahiro, Tsuboi, Tomofumi, Tsushima, Ken, Nakamura, Shinya, Hirano, Tetsuro, Ikemoto, Juri, Kiyoshita, Yusuke, Saeki, Sho, Tamura, Yosuke, Miyamoto, Sayaka, Nakamura, Kazuki, Furukawa, Masaru, Ishida, Katsunari, Arihiro, Koji, Uemura, Kenichiro, Aikata, Hiroshi
Format: Article
Language:English
Subjects:
Adenocarcinoma
Anesthesia
Bile ducts
Biopsy
Body size
Cancer
Carcinoma, Pancreatic Ductal - diagnosis
Carcinoma, Pancreatic Ductal - pathology
Catheters
Cellular biology
Cytology
Diagnosis
Early diagnosis
Endoscopic retrograde pancreatography
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endoscopy
Hospitals
Humans
Lesions
Medical diagnosis
Medical prognosis
Methods
Pancreas
Pancreatic cancer
Pancreatic ductal adenocarcinoma
Pancreatic Neoplasms
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - pathology
Pancreatitis
Pancreatography
Patients
Retrospective Studies
Statistical analysis
Surgical drains
Tails
Tumors
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Summary:Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is extremely useful for pathological diagnosis of pancreatic ductal adenocarcinoma (PDAC); however, puncturing is difficult in some cases, and there is a risk of needle tract seeding. This study evaluated the indications for endoscopic retrograde pancreatography-based (ERP)-based cytology for the preoperative diagnosis of PDAC. This study included 267 patients with PDAC who underwent preoperative ERP. The diagnostic performance of ERP-based cytology for PDAC was evaluated based on the sample collection method (pancreatic juice cytology [PJC] during ERP, brush cytology, PJC via endoscopic nasopancreatic drainage [ENPD] catheter), lesion site (pancreatic head, body/tail), and lesion size (≤10 mm, 10–20 mm, >20 mm), and compared with the diagnostic performance of EUS-FNA. The overall sensitivity of ERP-based cytology was 54.9%; sensitivity by the sampling method was 34.7% for PJC during ERP, 65.8% for brush cytology, and 30.8% for PJC via an ENPD catheter. The sensitivity of EUS-FNA was 85.3%. Brush cytology and PJC via an ENPD catheter were performed more often in pancreatic body/tail lesions than in head lesions (P = 0.016 and P 
ISSN:1424-3903
1424-3911
DOI:10.1016/j.pan.2022.02.001