Incremental Value of Cell Clock Preparations over Conventional Smears alone in the Evaluation of EUS-FNA for Pancreatic Masses

Background/Aims: The effectiveness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established for a definite pathological diagnosis of pancreatic solid masses. We investigated the usefulness of cell block preparations in EUS-FNA, by evaluating the added value of cell block preparations over conventional smears alone. Methodology: Between March 2011 and June 2013, 61 patients were retrospectively evaluated who underwent EUS-FNA for pancreatic solid masses. Diagnostic values for diagnosing pancreatic malignancy were compared for a combination of the conventional smear and cell block (CSCB) and the conventional smear alone (CS). Results: The addition of the cell block technique increased the sensitivity of conventonal smear for diagnosing the pancreatic malignancy from 79% (CS) to 90% (CSCB, p=0.0313) and the racy from 81% to 91% (p=0.0313). The specificity and positive predictive value were 100% in both methods The negative predictive value was increased from 33% (CS) to 50% (CSCB), but this difference was not cally significant (p=0.0833). Conclusion: The addition of the cell block method after a conventional smear may increase the sensitivity and negative predictive value for diagnosing the pancreatic malignancy in patients with pancreatic masses who undergo EUS-FNA. Further study may be warranted to determine whether the cell block method can replace the conventional smear.