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Endoscopic ultrasound with fine needle aspiration is useful in pancreatic cysts smaller than 3 cm
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Orientador(es)
Resumo(s)
Background: In current guidelines, endoscopic ultrasound with fne-needle aspiration (EUS-FNA) is recommended in pancreatic cystic lesions (PCLs) with worrisome features (size≥3 cm, mural nodule, or Wirsung dilation).
Objective: To evaluate the diagnostic ability and assess the accuracy of EUS-FNA in PCLs smaller than 3 cm.
Methods: Retrospective study of PCLs<3 cm (2007–2016) undergoing EUS-FNA. Clinical, EUS and pancreatic cystic fuid (PCF) data were prospectively registered. Performance of EUS-FNA with PCF analysis for the detection of malignancy and accuracy in surgical cohort were analyzed.
Results: We evaluated 115 patients with PCLs<3 cm who underwent EUS-FNA. 19 patients underwent surgery, 7 had malignant, 8 pre-malignant, and the remaining 4 benign lesions. Mass/mural nodule was present in 27% of the cysts, CEA level was higher than 192 ng/mL in 39.4% of patients, and only 35% of cytologic samples were informative. Nevertheless, additional FNA for PCF analysis improved the diagnostic performance of EUS imaging—AUC=0.80 versus AUC=60.
Conclusion: EUS-FNA has good accuracy in PCLs<3 cm. It confrmed malignancy even in lesions without worrisome features (nodule/mass), with two in every fve resections showing high-risk/malignant lesions. EUS-FNA was also useful to diagnose benign cysts, possibly allowing surveillance to be stopped in one in every fve patients.
Descrição
The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat iveco mmons .org/licen ses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creat ivecommons .org/publi cdoma in/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data
Palavras-chave
CEA Pancreatic cyst EUS-FNA IPMN MCN Small size
Contexto Educativo
Citação
BMC Gastroenterol 20, 413 (2020)
Editora
Springer Nature