Age and cystic size are associated with clinical impact of endoscopic ultrasonography-guided fine-needle aspiration on the management of pancreatic cystic neoplasms
Journal
Scandinavian journal of gastroenterology
Journal Volume
54
Journal Issue
4
Pages
506
Date Issued
2019-04
Abstract
Objectives: The clinical impact of endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) in managing pancreatic cystic neoplasms (PCNs) remains controversial. The aim of this study was to identify which patients with PCNs would benefit from EUS-FNA. Methods: A retrospective study was performed on patients with PCNs who underwent EUS-FNA between January 2009 and June 2018. A discordant or a consistent diagnosis after EUS-FNA was analyzed and was correlated with the clinical demographic data and cystic features. Predictors of the change in the diagnosis after EUS-FNA were analyzed. Results: One hundred eighty-eight cases of PCNs were analyzed. EUS-FNA changed the diagnosis in 45.7% of all patients with PCNs and 54.5% patients with presumed branch ductal type intraductal papillary mucinous neoplasm (BD-IPMN) and impacted the recommendation in 35.6% of patients with PCNs and 50.5% patients with BD-IPMN. Patients with a discordant diagnosis after EUS-FNA were younger in age (54.8 ± 12.6 vs. 61.2 ± 14.2; p=.037) and had a cyst size larger than 3 cm than patients with a consistent diagnosis after EUS-FNA. The only worrisome feature (WF) that differed between patients with a discordant and a consistent diagnosis after EUS-FNA was the main pancreatic duct (MPD) between 5 and 9 mm (p=.013). In multivariate analysis, a cyst size >3 cm and age were independent predictors of diagnostic changes after EUS-FNA (OR: 5.33, 95% CI: 1.79-15.88, p = .003; OR: 0.96, 95% CI: 0.93-0.99, p = .031). Conclusions: EUS-FNA made a significant change in the management of nearly half of the patients with PCNs, especially in younger patients and in patients with a cyst size larger than 3 cm.
Subjects
Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA); intraductal papillary mucinous neoplasm (IPMN); pancreatic cystic neoplasms (PCNs)
SDGs
Other Subjects
carcinoembryonic antigen; adult; Article; cystic neoplasm; disease association; endoscopic ultrasonography; endoscopic ultrasound guided fine needle biopsy; female; fine needle aspiration biopsy; human; intraductal papillary mucinous tumor; major clinical study; male; multivariate analysis; pancreas cyst; pancreatic cystic neoplasm; pancreatic duct; priority journal; retrospective study; age; aged; middle aged; pancreas cyst; pancreas pseudocyst; pancreas tumor; pathology; statistical model; Taiwan; Adult; Age Factors; Aged; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Female; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Pancreatic Cyst; Pancreatic Neoplasms; Pancreatic Pseudocyst; Retrospective Studies; Taiwan
Publisher
TAYLOR & FRANCIS LTD
Type
journal article