超声内镜引导下细针穿刺抽吸术对小胰腺癌诊断阳性率及术后并发症的影响

Influence of endoscopic ultrasound-guided fine needle aspiration on the positive rate of diagnosis and postoperative complications of small pancreatic cancer

目的探讨超声内镜引导下细针穿刺抽吸术(EUS-FNA)对小胰腺癌诊断阳性率及术后并发症的影响。方法选取2020年1月-2022年1月该院收治的小胰腺癌患者45例,均经术后病理学检查证实。所有患者术前采取EUS-FNA诊断,比较穿刺阳性与穿刺阴性患者的穿刺针数和每针提插数,采用单因素及多因素Logistic回归分析明确影响诊断阳性率的因素,同时比较出现并发症与未出现并发症患者的每针提插数情况。结果穿刺阳性患者的穿刺针数和每针提插数与穿刺阴性患者比较,差异无统计学意义(P>0.05);诊断阳性率在年龄、性别和病灶部位方面差异无统计学意义(P>0.05),在穿刺负压方面差异有统计学意义(P<0.05);多因素Logistic回归分析表明,10 mL负压穿刺能够提升诊断阳性率(P<0.05);与未出现并发症的患者比较,出现并发症的患者每针提插数明显增加(P<0.05)。结论将EUS-FNA应用于小胰腺癌的诊断中,采取10 mL负压穿刺能够提高诊断阳性率,而术后并发症受到每针提插数的影响,应尽量减少每针提插数。

Objective To investigate the positive rate of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)and the influencing factors of postoperative complications in the diagnosis of small pancreatic carcinoma.Methods 45 patients with small pancreatic carcinoma from January 2020 to January 2022 were selected.All of them were confirmed by post-operative pathological examination.EUS-FNA diagnosis was made before operation.The number of puncture needles and the number of lifts and inserts per needle of the patients with positive puncture and negative puncture were compared.The factors affecting the positive rate of diagnosis were determined by univariate and multivariate Logistic regression analysis.At the same time,the number of lifts and inserts per needle of the patients with and without complications were compared.Results There was no significant difference in the number of puncture needles and the number of lifting and inserting of each needle between the patients with positive puncture and the patients with negative puncture(P>0.05);There was no significant difference in age,sex and lesion location(P>0.05),but there was a significant difference in puncture negative pressure(P<0.05);By multivariate Logistic regression analysis,10 mL negative pressure puncture could improve the positive rate of diagnosis(P<0.05);Compared with the patients without complications,the number of lifting and inserting per needle in the patients with complications was significantly higher(P<0.05).Conclusion When EUS-FNA is applied to the diagnosis of small pancreatic carcinoma,10 mL negative pressure puncture can improve the positive rate of diagnosis.However,the postoperative complications are affected by the number of lifts and inserts per needle,and the number of lifts and inserts per needle should be reduced as much as possible.