内镜超声引导下细针穿刺对胰腺占位病变的诊断价值

Evaluation of endoscopic ultrasonography guided fine needle aspiration biopsy for pancreatic lesions

目的 通过超声内镜结合细针穿刺活检确定胰腺占位病变的性质 ,并评价该法对胰腺病变的诊断价值。方法 对经CT、MRI、体表腹部超声及内镜超声发现的 2 3例胰腺局限性占位病变进行内镜超声检查 ,以明确病变大小、形态、位置 ,并观察有无淋巴结转移。在内镜超声引导下对病变行细针穿刺活检。结果 2 3例患者中 ,2 1例得到了充足的细胞量 ,15例得到组织块 ,12例最终确定为胰腺肿瘤的患者 ,经组织细胞学检查 10例为阳性 (其中胰腺癌 8例 ;胰腺囊腺瘤癌 1例 ;无功能神经内分泌肿瘤 1例 ) ,敏感性为 83%,特异性为 10 0 %。全部结果经手术 (16例 )及临床随访 (7例 )证实。无 1例出现不良反应。结论 超声内镜结合细针穿刺是诊断胰腺病变安全、有效的方法。

Objective To determine the value of endoscopic ultrasonography (EUS)-guided fine needle aspiration biopsy (FNAB) for differential diagnosis of pancreatic lesions. Methods EUS was performed in 23 patients with pancreatic lesions detected by CT, MRI, or US to assess the shape, size, and position of the lesions and the status of lymph nodes metastasis. After excluding blood vessel between the lesions and the fine needle by EUS, EUS guided FNAB was carried out. Results All patients were performed EUS-guided FNAB and only 2 patients failed. Among the other 21 patients, cytology and pathology demonstrated tumors in 10 patients (pancreatic carcinoma, n=8; pancreatic cystadenoma, n=1; non functional neuroendocrine tumor, n=1). The results of EUS-guided FNAB were evaluated by surgery (n=16), or clinical follow-up (n=7). The sensitivity was 83%, and speciality was 100%, and no complication occurred. Conclusions EUS-guided FNAB is a safe and accurate method for differential diagnosis of pancreatic lesions.