超声内镜对胰腺癌诊断及评估价值

The value of endoscopic ultrasonography for diagnosing and assessing pancreatic cancer.

目的 探讨EUS诊断胰腺癌的敏感性、准确性及其评估肿瘤特征的价值。方法 以126例经病理确诊并在确诊前半月内先后接受EUS、US、CT检查的胰腺癌患者为研究对象,回顾性分析三种成像方法及EUS对于不同类型胰腺癌的检查结果,应用t检验或u检验评估这些检查结果的差异有无显著性。结果 EUS诊断胰腺癌准确性较US高,尤其对于小胰腺癌准确性更高,二者差异有显著性(P<0.05);EUS诊断敏感性、准确性与CT比较差异无显著性;联合应用EUS及CT检查,则诊断敏感性及准确性大为提高,与单独应用US、EUS或CT相比,差异均有显著性(P<0.05);EUS与CT显示肿瘤间接征象的准确性无显著性差异。结论 EUS对于胰腺癌是一种较好的检查方法,尤其对于怀疑为小胰腺癌者应作为常规检查。联合应用EUS和CT检查胰腺癌值得推广。

Objective To analyze the sensitivity and accuracy of endoscopic ultrasonography in diagnosing pancreatic cancer and assessing tumor features. Methods 126 patients with pathologically confirmed pancreatic cancer ( PC ) who had received endoscopic ultrasonography (EUS), Ultrasonography (US) and spiral computed tomography (CT) 15 days before diagnosis were selected as the subjects of the present study. The results of three imaging modalities and the results of some categories of PC on EUS were retrospectively analyzed and treated with the t-test or u-test to assess the significance of the differences of these results. Results The diagnostic rate of EUS was higher than that of US,especially in diagnosing small PC; the difference was significant(P<0. 05). There was no significant difference in sensitivity and accurate rate between EUS and CT. Combination of EUS with CT greatly increased the diagnostic sensitivity and accurate rate, and the difference was very significant between the combined modality and using US,EUS or CT alone(P<0. 05). There was no significant difference between EUS and CT in delineating the indirect signs of the tumors. Conclusions EUS is a preferable technique in detecting PC and should be used routinely for detecting small PC in particular. Combined use of EUS and CT to detect PC is recommended.