Comparison of ultrasonography-guided fine-needle aspiration and endoscopic ultrasonography-guided fine needle aspiration for the diagnosis of pancreatic malignancy.

OBJECTIVE: Both Ultrasonography-guided Fine Needle Aspiration (US-FNA) and Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA) are techniques commonly used for diagnosing pancreatic malignancies. However, comparative studies evaluating the diagnostic effectiveness of different imaging modalities in detecting pancreatic cancer are lacking. METHOD: A retrospective study of patients diagnosed with unresectable pancreatic cancer who underwent at least one imaging technique and underwent US-FNA or EUS-FNA between January 2019 and October 2022 was conducted. All patients' medical records were reviewed, and the following clinical data were extracted: sex, age, location and size of the lesion, uncinate, hypoechoic appearance, adequate specimen collection, time of pathological diagnosis, severe complications, repeat biopsy and pathology. To mitigate this bias, we implemented Propensity Score Matching (PSM). After matching, 35-pairs of patients were included. RESULTS: Among these patients, there was no significant difference in age, sex, location or size of the lesion, repeat biopsy or complications between US-FNA and EUS-FNA. Adequate specimens were obtained from 35 of 35 US-FNA patients and 29 of 35 EUS-FNA patients (100%vs. 82.9%). The rate of inconclusive pathological diagnosis was lower among patients who underwent US-FNA than those who underwent EUS-FNA (5.71%vs. 8.57%). US-FNA demonstrated a diagnostic accuracy of 82.9%, whereas EUS-FNA also had a diagnostic accuracy of 82.9%. CONCLUSION: US-FNA is an effective and safe option compared with EUS-FNA in the diagnosis of pancreatic malignancy. It is good choice to establish a definitive diagnosis with key biomarkers.