| Theme |
Role of Endoscopy in the Diagnosis and Treatments of Pancreatic Diseases |
| Title |
EUS-FNA for Diagnosis of Pancreatic Tumor |
| Author |
Nobumasa Mizuno |
Department of Castroenterology, Aichi Cancer Center Hospital |
| Author |
Noriyuki Hoki |
Department of Castroenterology, Aichi Cancer Center Hospital |
| Author |
Tadayuki Takagi |
Department of Castroenterology, Aichi Cancer Center Hospital |
| Author |
Akira Sawaki |
Department of Castroenterology, Aichi Cancer Center Hospital |
| Author |
Kenji Yamao |
Department of Castroenterology, Aichi Cancer Center Hospital |
| [ Summary ] |
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was developed to enhance the diagnostic capabilities of EUS by providing additional pathological findings. The indications for EUS-FNA for pancreatic lesions are as follows : histological evidence before chemotherapy and / or radiotherapy, cancer staging, and differential diagnosis of benign and malignant lesions.
Contraindications include situations in which FNA results do not affect management, cancers or vessels situated between the gut and the target and pancreatic cystic lesions suspected of being neoplastic pancreatic cystic tumors. The sensitivity, specificity and accuracy of EUS-FNA for diagnosing pancreatic cancer are reportedly 80 - 90 %, 100 % and 85 - 95 %, respectively. The overall complication rate appears to be 0 - 3 %. Therapeutic use of EUS-ENA, such as EUS-guided celiac plexus neurolysis, pancreatic tumor ablation and development of an anastomosis, are feasible and safe techniques. Focused DNA array analysis using pancreatic tissue obtained by EUS-FNA will provide a promising tool for individualized therapy for pancreatic cancer in the near future. |