术中细针穿刺细胞学检查在诊断胰腺肿瘤中的价值

The value of intraoperative fine needle aspiration cytology in diagnosis of pancreatic tumors

目的 评估术中细针穿刺细胞学检查对胰腺肿瘤的诊断价值。方法 回顾性分析62例胰腺肿瘤的术中细针穿刺细胞学检查、术中冰冻切片和手术探查、术后病理、术后随访的资料。结果 48例 (77.4% )胰腺肿瘤为恶性 ,14例 (2 2 .6% )为良性。细针穿刺细胞学检查和术中冰冻切片病理诊断胰腺癌的敏感性分别是 77.1%和 60 .4% ,精确度分别为 82 .3 %和 69.4% ,特异性均为 10 0 % ,两种方法差异无显著性 (P >0 .0 5 )。细针穿刺细胞学检查和术中冰冻切片病理检查联合诊断的敏感性和精确度为 87.5 %和 90 .3 % ,高于单一的诊断方法 (P <0 .0 5 )。结论 术中细针穿刺细胞学检查是判断胰腺肿瘤性质快速、简便、安全、有效的方法 ,具有较高的敏感性和特异性 ,与术中冰冻切片病理检查联合应用可进一步提高诊断的敏感性和精确性。

ObjectiveTo evaluate intraoperative fine needle aspiration cytology in diagnosis of pancreatic tumors.Methods62 patients with pancreatic tumors were diagnosed by intraoperative fine needle aspiration cytology(FNAC)and quick freezing section pathology(QFSP).All clinical data had been reviewed and compared with operative exploration,postoperative pathology and follow-up.Results48/62(77.4%)pancreatic tumors were malignant,and 14/62(22.6%)tumors were benign.The sensitivity of FNAC and QFSP was 77.1% and 60.4%,the accuracy was 82.3% and 69.4% respectively,and the specificity of both FNAC and QFSP was 100%.There was no statistic difference between two diagnostic methods(P>0.05).However,the combination between FNAC and QFSP was much better than each method in diagnosis of pancreatic tumor due to the higher sensitivity(87.5%) and accuracy(90.3%).ConclusionIntraoperative FNAC is a quick,easy,safe and effective method to diagnose pancreatic tumors due to its high sensitivity and perfect specificity.It is advocated to combine with QFSP to improve the diagnostic sensitivity and accuracy.