Diagnostic efficacy of endoscopic ultrasound-guided fine needle aspiration cytology in pancreatic lesions

Endoscopic Ultrasound (EUS) guided needle aspiration cytology (FNAC) is a rapid, reliable diagnostic procedure used in various benign and malignant pancreatic lesions. The present study was aimed to determine the diagnostic accuracy of endoscopic ultrasound-guided needle aspiration cytology (EUS-FNAC) in diagnosing pancreatic lesions. To the best of our knowledge, the first study of this kind in eastern India. The current study was a hospital-based prospective study. The study was conducted in a tertiary care hospital of eastern India over a period of two year. A total of 67 cases of radiologically detected pancreatic lesions were studied. Pancreatic lesions were sampled by EUS-FNA and cytology reporting was done basing on Papanicolaou Society for assessment of cytology of pancreatobiliary system (PSC)as well as new WHO system of reporting 2022. A simultaneous needle biopsy(FNAB)was done to reach at a final histopathology diagnosis. The Cytology reports were compared with the corresponding histology reports as the latter is considered to be the gold standard. Diff-Quik / PAP/H&E stains were routinely used for cytology, and H& E stain was used for corresponding histology sections. In morphologically challenging cases, immunohistochemistry was also done. The SPSS statistics software (version 16) was used for Statistical analysis. The study comprised a total of 67 pancreatic lesions cases with a mean age of 55.5 years and age range of 30–80 years. In both sexes, maximum cases were observed between 51 and 60 years. 42cases were males, whereas 25 cases were females (M: F = 1.7:1). The pancreatic head was the most involved site [29(43.28%) cases]. Among PSC categories; Category II (negative for malignancy) cases were highest in number(n = 27),then were the Category VI( positive or malignant ) i.e. (n = 25).Sensitivity, specificity, PPV, NPV and diagnostic accuracy were 84.6%, 60%, 58%, 85.71%&70.14% respectively. Whereas reanalysis done by WHO categories revealed; Sensitivity, specificity, PPV, NPV and diagnostic accuracy as87.5%, 82.8%, 82.3%, 87.8% &85.07%. EUS-FNA is an effective diagnostic procedure for differentiating malignant and benign pancreatic lesions. Hence, it is helpful for initiating an early management strategy.