胰腺占位经皮Trucut针穿刺活检的临床应用

Clinical application of percutaneous Trucut needle biopsy for pancreatic tumors

目的探讨超声或CT引导下经皮Trucut活检针穿刺活检对胰腺占位的诊断价值。方法对124例临床诊断胰腺癌但无病理诊断的患者在超声或CT引导下行经皮Trucut针穿刺活检检查。结果超声引导下穿刺109例，CT引导下穿刺15例。平均每例穿刺2．3次。124例患者均获取组织标本，病理诊断与临床符合率95．2％，其中腺癌115例，囊腺瘤5例，转移癌2例，来源不明癌1例，1例未见癌细胞。诊断敏感性99．2％，特异性100％，准确率99．2％。3例术后出现一过性血清淀粉酶升高；5例术后腹痛加重，均经对症处理后症状减轻；1例术后34d发现原穿刺部位皮下种植转移。无其他严重并发症。结论超声或CT引导下经皮胰腺肿物16～18GTrucut针穿刺活检是一种安全、简便、诊断准确率高的方法。

Objective To evaluate the diagnostic value of ultrasound or CT guided percutaneous Ttucut needle biopsy on the diagnosis of pancreatic tumors. Methods One hundred and twenty-four patients clinically diagnosed as pancreatic cancer without pathological diagnosis underwent pcrcutaneous pancreatic biopsy by using Trucut needle under ultrasound or CT guidance. Results One hundred and nine procedures of ultrasound-guided biopsy and 15 procedures of CT-guided biopsy were performed, and one patient received 2.3 times of punctures. Tissue samples were obtained in all 124 patients, the diagnostic accuracy was 95.2%, among them 115 were adenocarcinoma, 5 were cystadenoma, 2 were metastasis cancer, 1 was cancer of unknown origin and 1 was normal. The sensitivity, specificity, and accuracy were 99.2% 100%, and 99.2% , respectively. Transient serum amylase increase was observed in 3 patients; 5 patients＇ abdominal pain aggravated, but all recovered with conservative management. One patient was found to have tumor seeding on the spot of insertion after 34 days. No other major complications occurred. Conclusions Ultrasound or CT- guided percutaneous pancreatic 16 ~ 18G Trucut needle biopsy is a safe and simple procedure with excellent diagnostic value for pancreatic cancer.