超声引导细针穿刺细胞学检查在胰腺癌诊断中的应用  

Ultrasound-guided fine needle aspiration cytology in the diagnosis of pancreatic cancer

作　　者：王鹏[1] 刘鲁明[1] 孟志强[1] 陈震[1] 徐益语[1] 林钧华[1] 王龙富[2] 黄雅芳[3] 王柏华[3] 

机构地区：[1]复旦大学附属肿瘤医院中西医结合科,上海200032 [2]复旦大学附属肿瘤医院病理科,200032 [3]复旦大学附属肿瘤医院超声诊断科,200032

出　　处：《临床肿瘤学杂志》2007年第12期915-918,共4页Chinese Clinical Oncology

摘　　要：目的:评价超声引导下细针穿刺细胞学检查在胰腺癌诊断中的价值以及穿刺相关并发症。方法:2002年5月～2005年12月,我院临床诊断胰腺癌病例232例,对其中行胰腺穿刺的46例患者进行了回顾性分析。结果:46例患者中,男性33例,女性13例,平均年龄62.1岁(40～79岁)。穿刺结果显示:34例呈恶性,2例呈异形细胞,10例呈良性。其中34例恶性病例最终均被证实为胰腺癌,无假阳性病例;10例良性中最终证实5例为良性,5例为恶性。2例异形细胞被证实为恶性。5例真阴性病例包括2例胰腺囊肿、2例胰腺结核和1例胰腺炎。以上结果提示超声引导下细针穿刺其敏感性、特异性、阳性预测值、阴性预测值以及准确性分别为82.9%、100.0%、100.0%、41.7%和84.8%。46例病例中,11例患者出现穿刺后腹部轻微钝痛,但均自愈,未有出血、感染或胰腺炎等穿刺相关并发症,长期随访未发现有腹腔播散或者穿刺道种植等并发症。结论:超声引导下细针穿刺诊断胰腺癌准确性高,并发症少,值得临床进一步推广。Objective：To evaluate the role of ultrasound-guided fine needle aspiration （US-FNA） cytologic diagnosis in patients with clinically suspected pancreatic cancer, and to assess the complications related to US-FNA. Methods：From May 2002 to December 2005 there were 232 patients who presented with suspected pancreatic cancer treated in Cancer Hospital of Fudan University. We retrospectively reviewed the results of cytologic diagnosis obtained by FNA biopsy in 46 patients. Results：These 46 patients comprised 13 females and 33 males with a mean age of 62.1 years old（range, 40-79）. The cytologic diagnoses included： Thirty-four malignant, 2 atypical, 10 benign. Thirty-four cases were true positive, there was no false positive. The 10 benign patients were finally proven 5 maligant and 5 benign. Two atypical cases were all proven maglignant. The 5 ture negative diagnosis included 2 cysts of pancreas, 2 tuberculosis of pancreas and 1 pancreatitis. The sensitivity, specificity, positive predictive value（PPV）, negative predictive value （NPV）, and accuracy of US-FNA were 82.9%, 100.0%, 100.0%, 41.7% and 84.8%, respectively. Slight abdominal dull pain occurred in 11 of the 46 cases. But all were self-limited. Other complications related to FNA, such as hemorrhage, infection or pancreatitis were not noticed. No peritoneal dissemination and needle tract feeding were detected by follow-up. Conclusion：US-FNA is highly accurate in identifying patients with suspected pancreatic cancer and its complications are rare.

关 键 词：超声引导下细针穿刺 胰腺肿瘤 细胞学诊断 

分 类 号：R735.9[医药卫生—肿瘤]