Diagnostic Accuracy and Cytomorphological Analysis of Biliary Brush and Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS-FNA) of the pancreas based on The Papanicolaou Society of Cytopathology System

Abstract

Background
Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) of the pancreas and biliary brushes is a minimally invasive method of
cytology sampling. The purpose of this study was to determine the sensitivity, specificity, and accuracy of examination of biliary brush
cytology and EUS-FNA pancreas based on the System of standardized terminology and nomenclature for pancreatobilliary cytology
(STNPC) as well as cytology characteristics of pancreatic malignancy.
Methods
A search of the biliary brush preparation and EUS-FNA pancreatic in 2017-2020 was carried out in the Archives section of the Department of
Anatomical Pathology FKUI / RSCM. 506 cases of biliary brush cytology and EUS-FNA pancreatic, conducted a search of histopathological
preparations and re-categorized based on STNPC.
Results
Cytological cases of biliary brushing and pancreatic EUS-FNA paired with histopathology in 2017-2020 151 cases, 85 cases of biliary
brushing and 66 cases of pancreatic EUS-FNA, were re-categorized based on STNPC with results of biliary brushing 27 non-diagnostic
cases, 24 atypical cases, 7 suspicious for malignancy (SFM) cases and 17 malignant cases. Meanwhile, for pancreatic EUS-FNA cytology
16 non-diagnostic cases, 2 negative cases, 16 atypical cases, 3 other neoplasms, 4 SFM cases and 25 malignant cases. Twenty seven
cases of false negative biliary brushes on non-diagnostic and atypical preparations and 4 cases of false negative on pancreatic EUS-FNA on
non-diagnostic and atypical preparations. Biliary brushing diagnostic test results: sensitivity 82.35%, specificity 100%, positive predictive
value (PPV) 100%, negative predictive value (NPV) 84.21% and accuracy 90.9%. In pancreatic EUS-FNA: sensitivity 84.21%, specificity
100%, PPV 100%, NPV 986.67% and accuracy 92.86%.
Conclusion
Cytological diagnosis of biliary brushing and pancreatic EUS-FNA has good specificity, sensitivity and accuracy, but definitive diagnosis
requires histopathological examination