Citologia de aspirados por agulha fina ecoendoscopicamente guiada na avaliação de massas pancreáticas suspeitas de malignidade

Summary Background: Endoscopic ultrasound observations provide detailed imaging of pancreatic masses but, in many cases, is often unable to distinguish between benign and malignant lesions, having it to ultrasound-guided fine-needle aspira- tion cytology (EUS-FNAC) to achieve this differentiation. Aim: To investigate the feasibility and diagnostic accuracy of EUS-FNAC in patients with suspected pancreatic masses. Methods: All EUS-FNAs were performed by the same group of experienced endoscopists. On-site evaluation of specimen adequacy was done by a cytopathologist in each case. The cytopathological findings were compared with the final diagnosis provided by either clinical follow-up (at least twelve months) or surgical pathology. Results: EUS-FNACs were obtained from 80 patients. In the final diagnosis, 39 had malignant lesions and 41 benign ones. The cytology was positive for malignancy in 35 patients, negative in 34, suspicious in 3, atypical in 2 and the material was not adequate in 6. Considering only the 34 true positives, 33 true negatives, 1 false positive and 1 false negative, we obtained a sensitivity, specificity, accuracy, a positive predictive value and a negative predictive value of 97.1%, 97%, 97.1%, 97.1% and 97%, respectively. Including also the 11 patients where the cytology was sus- picious, atypical or without material, those values turned out to be 87.2%, 90.2%, 88.8%, 89.5% and 88.1%, respec- tively. Conclusions: With a well-trained group of endoscopists and cytopathologists, EUS-FNAC is able to diagnose pancreatic malignancy with a high degree of accuracy.