超声内镜引导下细针穿刺活检术在胰腺占位中的诊断价值

Diagnostic Value of EUS-FNA in Pancreatic Lesions

目的探究超声内镜引导下细针穿刺活检术(EUS-FNA)在胰腺占位中的诊断价值。方法研究对象选取2017年7—12月广州中山大学肿瘤防治中心内镜科60例胰腺占位,行超声内镜检查且行EUS-FNA的门诊及住院患者,记录EUS-FNA检查和诊断结果,并与金标准—最终诊断(手术病理诊断及随访结果给出最终诊断)进行比较。结果 60例患者行EUS-FNA均获得成功,穿刺成功率达100%。EUS显示48例实性占位、7例实性/囊性占位、5例弥漫性病变; 36例病灶位于胰头和颈部、24例病灶位于胰体和尾部,平均最大直径为(32. 58±19. 01) mm。EUS-FNA诊断准确率为80%,与金标准诊断比较差异无统计学意义。EUS-FNA诊断敏感度和特异度分别为86. 67%和90%。术后并发症发生率为6. 67%,未出现其他严重并发症和死亡情况。结论 EUS-FNA在胰腺占位中的诊断价值和安全性均较高。

Objective To explore the diagnostic value of EUS-FNA in pancreatic occupancy.Methods 60 cases of pancreatic space occupying endoscopy and EUS-FNA outpatient and hospitalized patients from July,2017 to December,2017 were selected from the Endoscopy Department,Center for Treatment and Prevention of Tumor,Zhongshan University.The results were recorded,and the final diagnosis(surgical pathology diagnosis and follow-up results)was given.The final diagnosis was compared.Results All 60 patients were successful in EUS-FNA,and the success rate of puncture was 100%.EUS showed48cases of solid space occupying,7cases of solid/cystic space,5 cases of diffuse lesions,36 lesions located in the head and neck of the pancreas,24 cases in the body and tail of the pancreas,and the average maximum diameter was(32.58±19.01)mm.The accuracy rate of EUS-FNA diagnosis was 80%.There was not significantly different from that of the gold standard,and the difference was not statistically significant.The sensitivity and specificity of EUS-FNA were 86.67% and 90%respectively.The incidence of postoperative complications was 6.67%,with no other serious complications and death occurance.Conclusion The diagnostic value and safety of EUS-FNA in pancreatic occupancy are high.