Hernández ROX, Martínez BB

Language: Spanish
References: 13
Page: 90-95
PDF size: 175.42 Kb.

ABSTRACT

Background: Endoscopic ultrasound-guided fine needle aspiration biopsy is a diagnostic procedure used to identify different gastrointestinal tract lesions with minimal complications.
Objectives: To assess the most important histological and cytological changes to diagnose pancreas cancer in endoscopic ultrasoundguided fine needle aspiration biopsy and to determine its diagnostic usefulness.
Material and methods: We reviewed 46 endoscopic ultrasound-guided fine needle aspiration biopsies of patients with clinical symptoms of pancreatic cancer. Two pathologists assessed the 46 biopsies independently and blinded to diagnosis and clinical evolution.
Results: The evaluation of biopsies showed 30 cases of carcinoma, 10 benign lesions and 6 with inadequate material for diagnosis. We identified some morphological features useful for the diagnosis of carcinoma. The most useful morphological criteria for the diagnosis of cancer were neoplastic cells with loss of adhesion, nucleomegaly, coarse chromatin, increase in the nucleus/cytoplasm ratio, nuclear pleomorphism, irregular nuclear membrane, prominent nucleoli, loss of polarity, nuclear pseudoinclusions, nuclear pseudostratification and coagulative necrosis. The most frequent morphological features in benign lesions were fat necrosis, acute inflammation and the presence of normal ductal epithelium. As a diagnostic method, the endoscopic ultrasound-guided fine needle aspiration biopsy showed sensitivity of 93.75%, specificity of 100%, positive predictive value of 100% and negative predictive value of 80%.
Conclusions: Some morphological changes for diagnosing pancreas adenocarcinoma have a good statistical significance, while others, despite of not being significant, are considered specific because they occur only in “malignant” cases; thus, endoscopic ultrasound-guided fine needle aspiration biopsy is a secure and useful method to diagnose carcinoma in patients with clinical and endoscopic suspicion.

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