超声内镜引导下细针穿刺联合肿瘤标志物对胰腺占位诊断价值及其影响因素

The diagnostic value and influencing factors of endoscopic ultrasonography-guided fine needle aspiration combined with tumor markers for pancreatic lesions

目的探讨肿瘤标志物联合超声内镜引导下细针穿刺(endoscopic ultrasonography-guided fine needle aspiration,EUS-FNA)对胰腺占位的诊断价值,并分析其相关影响因素。方法选取2021年8月至2022年8月于重庆医科大学附属第一医院确诊的68例胰腺占位患者,全部患者均完成EUS-FNA,分析患者的临床资料及病理结果。结果68例患者中,EUS-FNA对胰腺占位诊断的准确率为94.12%、灵敏度为92.86%、特异度为100%;EUS-FNA穿刺阳性患者年龄>60岁、胰腺占位大小>2 cm、穿刺次数≥3次的比例高于穿刺阴性患者;恶性胰腺占位组CA19-9水平高于良性胰腺占位组;CA19-9对恶性胰腺占位诊断的准确率为75.00%、灵敏度为75.00%、特异度为75.00%;CA19-9联合EUS-FNA对恶性胰腺占位诊断的准确率为97.06%、灵敏度为96.43%、特异度为100%。结论EUS-FNA诊断胰腺占位安全且准确率较高;EUS-FNA诊断胰腺占位的影响因素有穿刺次数、占位大小、年龄;EUS-FNA联合肿瘤标志物CA19-9可提高诊断胰腺占位的准确性。

Objective To investigate the value of tumor markers combined with endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA)for pancreatic mass and its related influencing factors.Methods A total of 68 patients with pancreatic mass in the First Affiliated Hospital of Chongqing Medical University from Aug.2021 to Aug.2022 were selected.All patients were treated with EUS-FNA,and the clinical data and pathological results of the patients were analyzed.Results The accuracy,sensitivity and specificity of EUS-FNA in the diagnosis of pancreatic mass were 94.12%,92.86%and 100%,respectively.The proportion of EUS-FNA puncture positive patients with age>60 years old,occupation size>2 cm,puncture times≥3 times were higher than that of puncture negative patients.The level of CA19-9 in malignant pancreatic mass group was higher than that in benign pancreatic mass group.The accuracy,sensitivity and specificity of CA19-9 in the diagnosis of malignant pancreatic lesions were 75.00%,75.00%and 75.00%,respectively.The accuracy,sensitivity and specificity of CA19-9 combined with EUS-FNA in the diagnosis of malignant pancreatic lesions were 97.06%,96.43%and 100%,respectively.Conclusion EUS-FNA is safe and accurate in the diagnosis of pancreatic mass.The influencing factors of EUS-FNA in diagnosis of pancreatic mass included puncture times,occupation size and age.EUS-FNA combined with tumor marker CA19-9 can improve the accuracy of diagnosis of pancreatic mass.