胰腺占位性疾病行超声内镜细针穿刺术结果分析

The results of 94 pancreatic mass underwent endoscopic ultrasonography-guided fine-needle aspiration identified by regular abdominal imagings

目的探讨超声内镜细针穿刺术(EUS-FNA)在常规影像学检查中发现的不明原因胰腺占位的诊断价值。方法选择南京医科大学鼓楼医院因胰腺占位原因待查住院病例,筛选出所有进一步接受超声内镜细针穿刺术检查的病例,总结资料完整的共94例。回顾性分析胰腺占位性病变的临床表现、EUS病变大小及部位、EUS表现特点、病理结果分析、最终病因分布、EUS-FNA对此类疾病的诊断价值。结果胰腺占位病变位于胰头的55例,位于胰体17例,位于胰尾22例。病变最小0.93cm×0.91cm,最大7.50cm×6.40cm,平均3.49cm×2.78cm。EUS-FNA检查病理结果阳性并明确诊断的71例,阳性率75.5%,之后选择手术并术后病理诊断22例。最终确诊的病例87例,分析病因分布为胰腺癌37例,胰腺黏液性囊腺瘤13例,胰腺实性假乳头状肿瘤5例,慢性胰腺炎6例,神经内分泌肿瘤7例,胰腺黏液性囊腺癌5例,浆液性囊腺瘤4例,自身免疫性胰腺炎3例,胰腺导管内乳头状黏液瘤2例,胰腺囊肿3例,胰腺结核2例。结论胰腺占位性病变的明确诊断是消化科的难点,EUSFNA对于胰腺占位性疾病尤其是胰腺相关恶性疾病是安全有效的重要诊断手段。

Objective To evaluate the diagnostic value of endoscopic ultrosonography-guided fine-needle aspiration for pancreatic mass identified on regular check-up. Methods Between January 1 2012 and November 30 2014, more than one hundred patients received endoscopic ultrosonography-guided fine-needle aspiration who were diagnosed with pancreatic mass in Drum Tower Hospital affiliated to Nanjing Medicial University. Ninety-four of them had complete medical records. Cardinal manifesitations, locations, features under endoscopic ultrasound,pathological diagnosis from FNA,and final diagnosis was analyzed. Results Fifty-five in 94 Pancreatic occupying lesion localized at the head of pancrease, 17 localized at the body of pancrease, 22 localized at the tail of pancreat. The EUS-FNA yielded the diagnosis of 71 cases of pancreatic mass. The positive rate was 75.5%, 22 underwent surgical interventions and had post operative pathological diagnosis. Among all the final diagnosis, 37 were pancreatic cancer, 13 were mucinous cystic neoplasms of the pancrease, 5 were solid pseudopapillary tumor, 6 were chronic pm^creatitis, 7 were pancreatic neurc^endocrine tumors, 5 were cystadenocarcinoma of the pancreatic, 4 were serous cystic neoplasm, 3 were autoimmune pancreatitis, 2 were intraductal papillary mucinous neoplasia, 3 were pancreatic cysts, 2 diagnosis of pancreatic mass is difficult, and EUS-FNA is a safe occupying lesion ,especially in malignant diseases. were pancreatic tuberculosis. Conclusion The definite and effective method for the diagnosis of pancreatic