Performance of eus-fnb in solid pancreatic masses: lesson from 463 consecutive procedures and a practical nomogram

Objectives: The study's main goal was the diagnostic adequacy of pancreatic EUS-FNB and associated predictive factors. The secondary objective was to define the diagnostic accuracy of EUS-FNB in the diagnosis of pancreatic masses and pancreatic malignancies. Methods: We retrospectively identified patients with solid pancreatic lesions that underwent EUS-FNB between 2013, and 2018. We calculated diagnostic adequacy and related factors. Using definitive histology on the surgically resected specimen as the gold standard, we calculated diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNB. Results: We identified a total of 463 procedures. Diagnostic specimens were adequate in 436 procedures (94.1%), while 27 biopsies provided insufficient samples (5.9%). The multivariate analysis showed that lesion size and needle caliper were the only factors influencing diagnostic adequacy. The use of a biopsy needle (OR=0.69, 95% IC 0.30-0.1.63, p=0.400) did not improve sample adequacy. We calculated sensitivity (89%), specificity (100%), diagnostic accuracy (91.9%), positive predictive value (100%), and negative predictive value (76.6%) using resected specimen as the gold standard. We found no significant complications. Conclusions: EUS-FNB is a reliable technique for the histological characterization of solid pancreatic masses.