Abstract
Objective : The optimal method for collecting samples by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), which is especially significant because only small amounts of samples can be obtained by this procedure, remains under debate. This study was aimed at clarifying how different collection methods can influence the cytological findings.
Study Design : We investigated the data of 37 subjects with pancreatic cancer who underwent EUS-FNA. The subjects were divided into 2 groups : the “Prior suction group”, representing samples obtained by the former 2 needle passes with suction and the latter 2 needle passes without suction, and the “Posterior suction group”, representing samples obtained by the former 2 needle passes without suction and the latter 2 needle passes with suction. Samples were individually prepared and evaluated cytologically.
Results : In the “Posterior suction group”, the number of atypical cells in the specimens obtained by the 2nd needle pass was larger than that in the samples obtained by the 3rd and 4th needle passes. In the “Prior suction group”, the number of atypical cells in the specimens obtained by the 4th needle pass was higher as compared with that in the samples obtained by the other needle passes. The number of atypical cells was higher in the “Posterior suction group”. The degree of cellular adhesion of the atypical cells was positively correlated with the cellularity.
Conclusion : Our findings suggest that the “Posterior suction method” may be better to obtain specimens for the diagnosis of pancreatic cancer by EUS-FNA. In poorly cohesive pancreatic cancer, it is important not to overlook the presence of a few atypical cells.
