ASPECTS OF PERCUTANEOUS FINE-NEEDLE ASPIRATION BIOPSY IN THE DIAGNOSIS OF PANCREATIC-CARCINOMA

BACKGROUND: Morphologic verification of malignancy is usually a prereq uisite before initiating nonsurgical therapy for pancreatic carcinoma. Fine-needle biopsy has been widely used, but the method has also been criticized because of inadequate sampling material and the risk of in tra-abdominal seeding. METHODS: Cytologic material from 334 patients w ith suspected pancreatic malignancy was evaluated with regard to the s ensitivity, specificity, and overall accuracy of the technique, The ou tcome (positive versus negative yield of cancer cells) was also entere d in a Cox bivariate regression analysis and tested against multiple p rognostic variables. RESULTS: In all, 270 patients had malignant disea se, which was verified cytologically in 187. The sensitivity, specific ity, and accuracy were 69%, 100%, and 75%, respectively. Statistically significant prognostic factors with regard to patient survival time w ere type of therapy (P <0.001), tumor location (P (0.001), jaundice (P <0.001), pain (P <0.001), and palpable mass (P <0.05). CONCLUSION: Fi ne-needle aspiration biopsy is still found to be a safe and feasible m ethod for diagnosing pancreatic cancer, providing the requisite diagno stic information before initiating nonsurgical therapy. (C) 1997 by Ex cerpta Medica, Inc.