Endoscopic ultrasonography (EUS) and fine-needle aspiration (FNA) cytology for diagnosis of XXXX .

@entity1 @entity32 @entity788 @entity66 @entity5 @entity1689 @entity2286 @entity730
BACKGROUND AND STUDY AIMS: Previous studies have shown that endoscopic ultrasonography (EUS) sensitively detects morphologic abnormalities due to @entity1689 . However, morphologic EUS findings have limited specificity, particularly at the early stages of @entity1689 . Our aims were to study pancreatic morphology and @entity32 in @entity1 with @entity1689 , using EUS and fine-needle aspiration cytology (EUS-FNA), and to compare the results with those of endoscopic retrograde cholangiopancreatography (ERCP) and pancreatic function tests. @entity1 AND METHODS: 37 @entity1 (48 +/- 13 years) with clinical symptoms and laboratory test findings suggestive of @entity1689 were prospectively studied. @entity1 with @entity5 or major concomitant disorders were excluded. Clinical evaluation included indirect pancreatic function tests. Morphologic criteria for @entity1689 included echo-intense septae/echo-reduced foci (i. e. pseudolobularity), ductal irregularities, and @entity730 . EUS-FNA was performed in 27/37 @entity1 , by means of the Hitachi FG34-UX echo endoscope and a 22-gauge needle, and tissue specimens were submitted for standard cytological evaluation. ERCP served as reference in all @entity1 , using the Cambridge classification. RESULTS: 31 @entity1 had @entity1689 while six had normal findings at ERCP. EUS showed morphologic @entity788 in 33 @entity1 . Morphologic abnormalities alone reached a sensitivity of 97 % for @entity1689 with a specificity of only 60 %, while the positive predictive value ( @entity2286 ) was 94 %, and the negative predictive value (NPV) was 75 %. EUS-FNA increased the negative predictive value to 100 % and the specificity to 67 %. On average, 2.3 needle passes were necessary to obtain sufficient amounts of tissue. The correlation of EUS findings with pancreatic function tests was poor. EUS results were in agreement with regard to the severity of @entity1689 in 5/8 @entity1 with grade I disease, in 11/13 @entity1 with grade II, and in 10/10 @entity1 with @entity66 . Minor complications occurred in two @entity1 (7 %). CONCLUSIONS: EUS is as sensitive and effective as ERCP in the detection of @entity1689 , particularly when only mild disease is present. However, EUS findings have limited specificity, particularly in @entity1 with mild disease. EUS-FNA with cytology is safe and improves the negative predictive value. Negative EUS-FNA findings rule out @entity1689 , but cytological investigation alone does not improve the specificity of EUS findings, suggesting that further improvements in tissue sampling and analysis are necessary to support routine use of FNA in @entity1 with @entity1689 .
