内镜超声检查对胰腺癌可切除性的评估

Assessment of resectability of pancreatic carcinoma by endoscopic ultrasonography

目的 应用内镜超声检查术 (EUS)对胰腺癌的可切除性进行前瞻性评估。方法 对初步诊断为胰腺癌的患者进行术前EUS ,由 2位内镜超声专家进行术前可切除性评估 ,以手术结果作为金标准进行对比 ,并与CT、MRI、B超诊断结果进行比较。结果 38例接受了手术治疗 ,其中 10例术前EUS认为可切除 ,实际术中切除 8例 ,EUS评估胰腺癌可切除性的准确度为 80 0 % ;2 8例术前EUS评估为不可切除 ,实际手术无法切除 2 7例 ,EUS评估不可切除准确度为 96 4 %。提示EUS术前评估结果与手术结果一致性较好。EUS诊断胰腺癌准确率为 97 4 % ,CT为 94 6 % ,MRI为 89 5 % ,B超为73 7%。

Objective To discover the value of endoscopi c ultrasonography (EUS) in predicting the resectability of pancreatic carcinoma.Methods Thirty-eight consecutive patients were prospectively i nvestigated using EUS to determine the tumor resectability. Two specialists eval uated the EUS findings in each of the patients prospectively. All patients were explored and their resectability noted. In the meantime, we compared the accurac y of EUS diagnosis with that of CT, MRI and sonography respectively.Results Ten out of 38 cases with pancreatic carcinoma were cons idered to be resectable by EUS with a positive predictive value of 80 0% in com parison with surgical findings. EUS also had high correlation with surgical resu lts in assessing un-resectability of pancreatic carcinoma, the negative predic tive value is 96 4%. There was 1 false negative and 2 false-positive assessmen ts (sensitivity, 88 9% and specificity, 93 1%). The accuracy of EUS was the hi ghest. The diagnostic accuracy of EUS, CT, MRI and sonography were 97 4%, 94 6 %, 89 5% and 73 7% respectively.Conclusion It is an effective method to use endoscopic ultrason ography in predicting the resectability of pancreatic carcinoma before operation .