Multicenter Study of Pancreatic Juice Cytology Scoring System for Differential Diagnosis in Pancreatic Neoplasm
Yoshiaki Uchida, Kaori Abe, Takahiko Nakajima, Shigeharu Miwa, Shinichi Hayashi, Kazuhiro Nomoto, Koichi Tsuneyama, Johji Imura. Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan; Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
Background: We perform multicenter study for diagnostic precision improvement of the pancreatic juice cytology and examined the scoring system for the differential diagnoses in pancreatic neoplasm.
Design: The pancreatic juice cytology specimens were obtained from the patients pathologically diagnosed with intraductal papillary mucinous adenoma/carcinoma: IPMA/C and invasive ductal carcinoma: IDC. Using the virtual slide microscopy, twenty-eight cytotechnologists of many institutes participated in this examination. Several multivariate analyses were carried out to sort the diagnostic clue of cell findings to be important. Furthermore, ROC analysis was performed whether it was diagnostic using the selected factors.
Results: As a result of multivariate analysis, the important findings to distinguish adenocarcinoma from adenoma were the mucinous background, the intracytoplasmic mucin, the cellular stratification, the peripheral irregularity of cell cluster, the irregular nuclear arrangement, the irregular nuclear appearance and the abnormal chromatin distribution. By the ROC analysis, the degree of precision for the differential diagnosis showed the 96 % of sensitivity and the 90% of specificity between the IPMAs and the IPMCs, and showed the 86% of specificity and the 96% of sensitivity between the IPMAs and the IPMCs+IDCs.
Conclusions: By using pancreatic juice cytology in this scoring system, the possibility to determine with high accuracy IPMA and IPMC was suggested. This diagnostic system might be expected as an examination to contribute to the patient stratification.
Wednesday, March 6, 2013 1:00 PM
Poster Session VI # 127, Wednesday Afternoon