内镜超声引导下的细针穿刺/活检（EUS-FNAB）对于直径≤10毫米的胰腺导管腺癌（PDAC）的诊断表现相对较低。胰液细胞学（PJC）因其对小型PDAC具有较高的敏感性而受到关注。我们旨在澄清EUS-FNAB的诊断能力以及PJC对≤10毫米PDAC的救援能力。我们对经EUS确认的≤10毫米胰腺肿瘤（排除胰腺转移/恶性淋巴瘤）尝试进行EUS-FNAB的患者获取的数据进行回顾性分析。在技术失效/阴性EUS-FNAB结果的患者中，根据影像特征，具有高度可疑PDAC的患者进行PJC。根据切除的组织学标本、影像检查上EUS-FNAB阳性的肿瘤生长，或肿瘤增大后的额外EUS-FNAB阳性结果来诊断PDAC。主要终点是EUS-FNAB对≤10毫米PDAC的诊断能力。还评估了PJC的救援能力。总体而言，在尝试EUS-FNAB的≤10毫米胰腺肿瘤患者中，有86例被诊断为PDAC，共计271例患者。EUS-FNAB对于≤10毫米PDAC的技术成功率、敏感性、特异性和准确性分别为80.8%、82.3%、94.9%和91.3%。在经历了EUS-FNAB技术失败/假阴性结果的35例PDAC患者中，有26例（74.3%）通过救援PJC被准确诊断。EUS-FNAB对于≤10毫米PDAC的真实成功率/敏感性相对较低。在EUS-FNAB对于强烈疑似为PDAC的≤10毫米胰腺病变无法成功或给出阴性结果的情况下，建议进行PJC。版权所有 © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. 保留所有权利。

The diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNAB) for pancreatic ductal adenocarcinoma (PDAC) ≤ 10 mm in diameter is relatively low. Pancreatic juice cytology (PJC) has gained attention owing to its high sensitivity for small PDAC. We aimed to clarify the diagnostic ability of EUS-FNAB and the salvage ability of PJC for PDAC ≤ 10 mm.The data obtained from attempted EUS-FNAB for patients with EUS-confirmed pancreatic tumors ≤ 10 mm (excluding pancreatic metastases/malignant lymphomas) were retrospectively analyzed. Patients who experienced technical failure/negative EUS-FNAB result and had a strong likelihood of PDAC based on imaging characteristics underwent PJC. PDAC was diagnosed using resected histological specimens, EUS-FNAB-positive tumor growth on the imaging examination, or additional EUS-FNAB-positive results after increase in tumor size. The primary endpoint was the diagnostic ability of EUS-FNAB for PDAC ≤ 10 mm. The salvage ability of PJC was also assessed.Overall, 86 patients were diagnosed with PDAC of 271 patients with pancreatic tumors ≤ 10 mm who underwent attempted EUS-FNAB. The technical success rate, sensitivity, specificity, and accuracy of EUS-FNAB for PDAC ≤ 10 mm was 80.8%, 82.3%, 94.9%, and 91.3%, respectively. Among the 35 PDAC patients who experienced technical failure/false-negative result of EUS-FNAB, 26 (74.3%) were correctly diagnosed using salvage PJC.The true success rate/sensitivity of EUS-FNAB for PDAC ≤ 10 mm was relatively low. When EUS-FNAB for a pancreatic lesion ≤ 10 mm strongly suspected to be PDAC is unsuccessful or yields a negative result, PJC is recommended.Copyright © 2023 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.