Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2016; 8(9): 656-662
Published online Sep 15, 2016. doi: 10.4251/wjgo.v8.i9.656
Role of the preoperative usefulness of the pathological diagnosis of pancreatic diseases
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Masaru Ueki, Norimasa Miura, Hajime Isomoto
Kazuya Matsumoto, Yohei Takeda, Takumi Onoyama, Soichiro Kawata, Hiroki Kurumi, Hajime Isomoto, Department of Gastroenterology, Tottori University Hospital, Yonago 683-8504, Japan
Masaru Ueki, Department of Next Generation Advanced Medical Promotion Center, Tottori University Hospital, Yonago 683-8504, Japan
Norimasa Miura, Division of Pharmacotherapeutics, Department of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
Author contributions: Matsumoto K drafted the manuscript; Matsumoto K and Ueki M concept and designed the study; Takeda Y, Onoyama T, Kawata S and Kurumi H collected the data; Ueki M and Miura N analyzed and interpreted the data; Isomoto H revised the manuscript.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Kazuya Matsumoto, MD, PhD, Department of Gastroenterology, Tottori University Hospital, 86 Nishi-cho, Yonago 683-8504, Japan.
Telephone: +81-859-386527
Received: July 27, 2015
Peer-review started: August 21, 2015
First decision: October 21, 2015
Revised: November 29, 2015
Accepted: July 28, 2016
Article in press: August 1, 2016
Published online: September 15, 2016

Pancreatic cancer is the fifth leading cause of cancer death and has the lowest survival rate of any solid cancer. Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is currently capable of providing a cytopathological diagnosis of pancreatic malignancies with a higher diagnostic power, with a sensitivity and specificity of 85%-89% and 98%-99%, compared to pancreatic juice cytology (PJC), whose sensitivity and specificity are only 33.3%-93% and 83.3%-100%. However, EUS-FNA is not effective in the cases of carcinoma in situ and minimally invasive carcinoma because both are undetectable by endoscopic ultrasonography, although PJC is able to detect them. As for the frequency of complications such as post endoscopic retrograde cholangiopancreatography pancreatitis, EUS-FNA is safer than PJC. To diagnose pancreatic cancer appropriately, it is necessary for us to master both procedures so that we can select the best methods of sampling tissues while considering the patient’s safety and condition.

Keywords: Endoscopic ultrasound-guided fine-needle aspiration biopsy, Cytology, Pathology, Pancreatic juice cytology, Pancreatic cancer

Core tip: In the era of cyto-pathological diagnosis of pancreatic cancer, endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) and pancreatic juice cytology (PJC) represent the most promising procedures for diagnosing pancreatic malignancies. However, there haven’t been any reports that compared the utilities and faults of these procedures. In this review we have highlighted the current role of EUS-FNA and PJC in the diagnosis process for pancreatic malignancies.