摘要
目的评价内镜超声检查术(EUS)联合内镜超声引导下细针穿刺术(EUS-FNA)的囊液分析、细胞学、组织病理学等对胰腺囊性病变的诊断价值。方法回顾性分析2006年1月至2015年4月疑为胰腺囊性病变且最终行外科手术的患者共45例。搜集45例患者既往行传统影像学(超声、CT、MRI、MRCP等)、EUS、EUS-FNA检查的临床资料,根据术后病理诊断结果对比传统影像学检查和EUS联合EUS-FNA2种检查技术对胰腺囊性病变的诊断效果。结果胰腺囊性非肿瘤性病变8例、浆液性囊腺瘤4例、黏液性囊腺瘤11例、导管内乳头状黏液瘤8例、实性假乳头状瘤5例、胰腺非囊性病变9例。传统影像学检查(超声、CT、MRI、MRCP等)、EUS-FNA与术后病理诊断准确率分别为:42.2%(19/45)、77.8%(35/45),差异具有统计学意义(P〈0.05)。EUS.FNA相比传统影像学检查诊断胰腺囊性病变的价值为高,特异度、敏感度、阳性预计值、阴性预计值分别为58.3%(7/12)、97.0%(32/33)、86.5%(32/37)、87.5%(7/8)与41.7%(5/12)、87.9%(29/33)、80.6%(29/36)、55.6%(5/9)。结论EUS—FNA较传统影像学检查诊断胰腺囊性病变更有价值。
Objective To evaluate the effects of endoscopic ultrasonography (EUS) combined with cyst fluid analysis, cytology., histopathology based on endoscopic ultrasound guided fine needle aspiration (EUS-FNA) on pancreatic cystic lesions (PCLs). Methods Clinical data of 45 patients were analyzed ret- rospectively from January 2006 to April 2015 including MRI, EUS-FNA, MRCP. The results of conventional imaging and EUS-FNA were compared based on postoperative pathology. Results There were 8 cases of non tumor pancreatic cystic lesions, 4 cases of serous eystadenoma ( SCN), 11 cases of mucinouseystadenoma (MCN), 8 cases of intraductal papillary mucinous tumor (IPMN), 5 cases of solid pseudopapillary papilloma (SPN) , 9 cases of non pancreatic cystic lesions (nPCLs). The diagnostic accuracy rate of tradi- tional imaging tests ( B-ultrasound, CT, MRI, MRCP) and EUS-FNA were 42. 2% (19/45) and 77.8% (35/45) (P〈0. 05). The diagnostic value of EUS-FNA of PCLs was higher than that of traditional imaging tests, with specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of 58.3% (7/12), 97.0% (32/33), 86. 5%(32/37), 87. 5% (7/8) and 41.7% (5/12), 87.9% ( 29/33), 80. 6% ( 29/36 ), 55.6% ( 5/9 ), respectively. Conclusion EUS-FNA is more valuable than traditional imaging tests for the diagnosis of PCLs.
出处
《中华消化内镜杂志》
北大核心
2016年第7期433-436,共4页
Chinese Journal of Digestive Endoscopy
关键词
胰腺肿瘤
囊性
内窥镜检查
超声检查
活组织检查
细针
诊断
鉴别
Pancreatic neoplasms,cystic
Endoscopy
Ultrasonography
Biopsy, fine-needle
Diagnosis, differential