Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration

Table 1 Diagnostic evaluation before EUS

Imaging modalities	n	%
Only CT	289	47.3
CT + MRI	190	31.1
CT + ERCP	120	19.6
CT + MRI + ERCP	12	2.0

CT: Computed tomography; MRI: Magnetic resonance imaging; ERCP: Endoscopic retrograde colangiopancreatography.

Table 2 Location of the pancreatic tumors in patients submitted to EUS-FNA

	Head1	Body2	Tail	Total
Solid tumors ≥ 3 cm	169	42	14	225
Solid tumors < 3 cm	119	52	9	180
Cystic lesions	122	67	17	206
Total	410	161	40	611

¹Lesions in the head, uncinate process and pancreatic neck were grouped together.

²Tumors invading body and tail were grouped as body lesions.

Table 3 Diagnoses of pancreatic lesions obtained by surgery and clinical follow-up (n = 611)

Tumour	Type	n
Solid (405)	Adenocarcinoma	233
	Focal Chronic Pancreatitis	87
	Neuroendocrine tumo	46
	Metastasis	13
	Lymphnode	9
	Splenosis	4
	Lymphoma	4
	Autoimmune pancreatitis	4
	Adenoma	2
	Sarcoma	2
	Blastomycosis	1
Cystic (189)	Pseudocyst	84
	Serous cystadenoma	42
	Mucinous cystadenoma	18
	IPMT	18
	Abscess	12
	PanIN	8
	Chronic Pancreatitis	4
	Tuberculosis	2
	Neuroendocrine tumor	1
Mixed (17)	Cystadenocarcinoma	8
	Adenocarcinoma	3
	Frantz tumor	3
	IPMT	1
	Metastasis	1
	Neuroendocrine tumor	1

IPMT: Intraductal papillary mucinous tumor; PanIN: Pancreatic intraepithelial neoplasia.

Table 4 Sensitivity, specificity, positive and negative predictive values and accuracy of EUS-FNA in the diagnosis of pancreatic tumors

	General(n = 611)		Solid tumors≥3 cm(n = 225)		Solid tumors < 3 cm(n = 180)		Cystic lesions(n = 206)
	%	95% CI	%	95% CI	%	95% CI	%	95% CI
Sensitivity	78.4	74.1-82.8	78.8	72.8-84.8	82.4	75.5-89.2	72.2	60.3-84.2
Specificity	99.2	98.1-100	100	100-100	98.4	95.2-100	99.3	98.1-100
PPV	99.3	98.2-100	100	100-100	99.0	97-100	97.5	92.7-100
NPV	77.2	72.6-81.7	54.8	44.1-65.4	74.1	64.5-83.6	91.0	86.6-95.3
Accuracy	87.2	84.5-89.9	83.1	78.2-88	87.8	83-92.6	92.2	88.6-95.9