Evaluation of Percutaneous Ultrasound-guided Biopsy for Pancreatic Neoplasms: A Case-control Study

  Objective  This study aimed to evaluate the diagnostic value of percutaneous ultrasound-guided (US-guided) biopsy for pancreatic neoplasms, and to compare the evaluation of fine needle aspiration(FNA) and core needle biopsy (CNB).

  Methods  Data of consecutive patients who had percutaneous US-guided biopsies of pancreatic masses for the diagnosis of suspiciously malignant solid pancreatic masses in Peking Union Medical College Hospital between January 2014 and April 2017 were retrospectively analyzed. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated based on the biopsy methods (FNA vs. CNB). The final diagnosis was determined according to a combination of follow-up (no shorter than 6 months) imaging, clinical course evaluation, repeated biopsy and/or surgical pathology.

  Results  A total of 160 patients who met the inclusion and exclusion criteria were enrolled in this study, including 95 in the FNA group and 65 in the CNB group. The overall sensitivity, specificity, PPV, NPV, and accuracy of percutaneous US-guided biopsy were 93.8%, 100%, 100%, 64.0%, and 94.4%, respectively. The sensitivity, NPV, and accuracy of the CNB group were higher than those of FNA group (94.7% vs. 93.1%,72.7% vs. 57.1%,95.4% vs. 93.7%), but there was no statistical difference between the two groups. Two cases with major complications (1.3%, 2/160) were observed, including one acute pancreatitis and one tumor seeding.

  Conclusions  Percutaneous US-guided biopsy is an effective and safe diagnostic method for pancreatic neoplasms. The current data do not suggest significant differences in the diagnostic efficacy of FNA and CNB.