Diagnostic efficacy of cell block immunohistochemistry, smear cytology, and liquid-based cytology in endoscopic ultrasound-guided fine-needle aspiration of pancreatic lesions: a single-institution experience
- PMID: 25259861
- PMCID: PMC4178202
- DOI: 10.1371/journal.pone.0108762
Diagnostic efficacy of cell block immunohistochemistry, smear cytology, and liquid-based cytology in endoscopic ultrasound-guided fine-needle aspiration of pancreatic lesions: a single-institution experience
Abstract
Background: The diagnostic efficiency of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) cytology varies widely depending on the treatment method of the specimens. The present study aimed to evaluate the diagnostic efficacy of cell block (CB) immunohistochemistry, smear cytology (SC), and liquid-based cytology (LBC) in patients with pancreatic lesions without consulting an on-site cytopathologist.
Methods: This study prospectively enrolled 72 patients with pancreatic lesions. The EUS-FNA specimens were examined by SC, LBC, and CB immunohistochemistry. The diagnostic efficacy of the 3 methods was then compared. Patients' final diagnosis was confirmed by surgical resection specimens, diagnostic imaging, and clinical follow-up.
Results: Our results included 60 malignant and 12 benign pancreatic lesions. The diagnostic sensitivity (90%), negative predictive value (66.7%), and accuracy (91.7%) of CB immunohistochemistry were significantly higher than those of SC (70.0%, 30.0%, and 75.0%, respectively) and LBC (73.3%, 31.6%, and 77.8%, respectively) (all P<0.05). The combination of CB and SC, or CB and LBC, did not significantly increase the efficacy compared to CB immunohistochemistry alone.
Conclusion: Our findings suggest that in the absence of an on-site cytopathologist, CB immunohistochemistry on EUS-FNA specimens offers a higher diagnostic efficacy in patients with pancreatic lesions than does SC and LBC.
Conflict of interest statement
References
-
- Agarwal B, Krishna NB, Labundy JL, Safdar R, Akduman EI (2008) EUS and/or EUS-guided FNA in patients with CT and/or magnetic resonance imaging findings of enlarged pancreatic head or dilated pancreatic duct with or without a dilated common bile duct. Gastrointest Endosc 68: 237–242; quiz 334, 335. - PubMed
-
- Volmar KE, Vollmer RT, Jowell PS, Nelson RC, Xie HB (2005) Pancreatic FNA in 1000 cases: a comparison of imaging modalities. Gastrointest Endosc 61: 854–861. - PubMed
-
- Klapman JB, Logrono R, Dye CE, Waxman I (2003) Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol 98: 1289–1294. - PubMed
-
- Layfield LJ, Bentz JS, Gopez EV (2001) Immediate on-site interpretation of fine-needle aspiration smears: a cost and compensation analysis. Cancer 93: 319–322. - PubMed
-
- Linder J (1998) Recent advances in thin-layer cytology. Diagn Cytopathol 18: 24–32. - PubMed
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