超声内镜引导下穿刺诊断胰腺癌的方法研究进展  

Progress of diagnostic methods of pancreatic cancer by endoscopic ultrasound-guided fine-needle aspiration

作　　者：李晨帆 吴立桦 郑泽宇 郑月萍 谢韵 刘婕 吴碧芳 苏瑞章 万曼 田钊旭 胡益群[1,2] Li Chenfan;Wu Lihua;Zheng Zeyu;Zheng Yueping;Xie Yun;Liu Jie;Wu Bifang;Su Ruizhang;Wan Man;Tian Zhaoxu;Hu Yiqun(Department of Gastroenterology,Zhongshan Hospital of Xiamen University,School of Medicine,Xiamen University,Xiamen 361004,China;The Third Clinical Medical College,Fujian Medical University,Fuzhou 350004,China;Department of Gastroenterology,The Jingzhou First People's Hospital,Jingzhou 434000,China;Department of Gastroenterology,Shenzhen Longgang District People's Hospital,Shenzhen 518172,China)

机构地区：[1]厦门大学附属中山医院消化内科,福建厦门361012 [2]福建医科大学第三临床医学院,福州350004 [3]荆州市第一人民医院消化内科,湖北荆州434000 [4]深圳市龙岗区人民医院消化内科,广东深圳518172

出　　处：《中华消化病与影像杂志（电子版）》2022年第2期102-107,共6页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：厦门市医疗卫生指导性项目(3502Z20214ZD1044)

摘　　要：超声内镜引导下细针穿刺活检(EUS-FNA)是一种较为安全、并发症少的诊断方法,是获取少量胰腺组织的简便方法。对穿刺获得的组织、囊液、洗脱液等标本进行进一步检查是辨别胰腺病变良恶性的有效措施。如何选择最佳的诊断方法,从而提高EUS-FNA的诊断效能是临床面临的重要课题。本文总结了目前临床常见的EUS-FNA辅助诊断方法,如细胞学、肿瘤标志物、基因检测等,并比较了不同方法的优缺点。液基细胞学检查不如传统涂片方法的细胞异型性明显,但减少了样品背景的污染。在肿瘤标志物及基因检测方面,除了p53、KRAS、糖类抗原等标志物,SMAD4基因、IMP3、S100P蛋白等也是经研究证实有诊断价值的生物标志物。新技术如高通量测序有成为临床检测方法的潜能,在有足够人手的医院,也推荐实施快速现场评价技术。Endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)is a relatively safe diagnostic method with fewer complications,and a simple method to obtain a small amount of pancreatic tissue.Further examination of tissue,cystic fluid and washing fluid obtained by aspiration is an effective way to distinguish benign and malignant pancreatic lesions.How to select the best diagnostic method to improve the diagnostic efficiency of EUS-FNA is an important topic in clinical research.This review discusses common diagnostic methods of EUS-FNA,such as cytology,tumor markers,gene testing,and the advantages and disadvantages of different methods are compared.Liquid-based cytology lacks uniformity compared to the conventional smear method but reduces contamination of the background.In terms of the detection of tumor markers and genes,in addition to p53,KRAS,carbohydrate antigen,SMAD4 gene,IMP3,S100P protein are also worthy biomarkers confirmed by studies.New technology such as high-throughput sequencing has the potential to be used in clinical practice,and rapid on-site evaluation is recommended in fully staffed hospitals.

关 键 词：超声内镜引导下穿刺 细胞学 基因 肿瘤标志物 诊断 

分 类 号：R735.9[医药卫生—肿瘤] R445.1[医药卫生—临床医学]