Comprehensive analysis of pancreatic fine needle aspiration cyto-histopathological correlation.

Objective: Pancreatic cancer is a major global health challenge with high mortality rates and limited therapeutic options. Fine-needle aspiration (FNA) cytology is a key diagnostic tool, but discrepancies between cytological and histological diagnoses can impact patient management. This study aims to evaluate the diagnostic accuracy of pancreatic FNA using the World Health Organization (WHO) reporting system to assess the risk of malignancy (ROM) across different diagnostic categories.

Material and methods: The WHO reporting system was employed to reclassify 122 FNAs, with 37 cases undergoing subsequent histological correlation to evaluate the ROM. The sensitivity, specificity, positive and negative predictive values, and accuracy of ROM using the WHO system were determined through statistical analyses.

Results: The discrepancy rate between cytology and histology diagnoses was 16.2%. Category 6 (malignant) showed consistent ROM values (89%), confirming its reliability in predicting malignancy. However, Categories 1, 2, and 3 had higher ROM values than previously reported, while Category 4 had a lower ROM. Factors such as small lesion size, poor cellularity, and sampling limitations contributed to diagnostic discrepancies.

Conclusion: The study offers significant insights into the cyto-histopathological correlation in pancreatic FNA, highlighting the effectiveness of the WHO reporting system in ROM assessment. Future research with larger samples is necessary to enhance the accuracy of pancreatic FNA cytology for improved patient outcomes.