Sensitivity and specificity of sonographically guided fine-needle puncture (FNP) in the diagnosis of focal lesions of the pancreas

Introduction: Studies of FNP in the diagnosis of focal lesions of the pancreas have reported a sensitivity of 57-93% and a specificity of 95-100% for the method. The objective of the present investigation was to evaluate the sensitivity and specificity of FNP in the diagnosis of focal lesions of the pancreas. Patients and Methods: Between May, 1995 and June, 1996 we performed FNP on 25 patients (14 females, 11 males; average age 61.4 + 10.91 years, range 31-77 years). In nine cases, confirmation of findings was surgical, in the remaining 16 patients based on a one-year clinical follow-up period. Results: Aspiration of diagnostically adequate material was possible in 18 cases (72%) (malignancy, 10; chronic pancreatitis, 4; benign lesions, 4). For the other seven patients (28%), clinical follow-up revealed pancreatic carcinoma in two patients, pancreatitis in four patients, while in one case even the surgical specimen obtained for histologic examination failed to provide a diagnosis. For patients with adequate cytology findings, one-year follow-up revealed false-negative findings in three cases: three of four patients with chronic pancreatitis developed carcinoma. Discussion.: FNP in the diagnosis of focal pancreatic lesions showed a sensitivity of 77% and a specificity of 100%. There were no complications observed in our group. Conclusion: Negative findings at FNP in chronic pancreatitis does not exclude the possibility of carcinoma. In the case of equivocal findings, criteria for surgery should be broad.