超声内镜引导细针穿刺活检对胰腺占位性病变的诊断价值  

Evaluation of endoscopic ultrasound-guided fine needle aspiration of space-occupying lesion of the pancreas

作　　者：郭文[1,2] 雷姗[1,2] 程天明[1,2] 朱微[1,2] 姚永莉[1,2] 周丹[1,2] 智发朝[1,2] 姜泊[1,2] 

机构地区：[1]南方医科大学南方医院消化科 [2]广东省胃肠疾病重点实验室,510515

出　　处：《现代消化及介入诊疗》2010年第4期223-226,共4页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的探讨超声内镜引导下细针穿刺活检(EUS-FNA)对胰腺占位性病变的诊断价值。方法回顾分析2009年1月至2010年1月间行EUS-FNA的35例胰腺占位病例,与CT、B超、临床表现等进行对比分析,依病理学和细胞学检查或随访结果确诊。结果在所有35例患者中,最后确诊胰腺癌23例、慢性胰腺炎9例、导管内黏液性乳头状瘤1例、胰腺假性囊肿1例、浆液性囊腺瘤1例。B超共检出胰腺病变22例,CT29例,EUS发现35例可疑胰腺病变。对所有患者均行EUS-FNA检查,获得满意标本34例,取材满意率97.14%。EUS-FNA诊断胰腺癌17例,敏感性为73.91%,EUS-FNA总准确率为82.86%。5例患者EUS-FNA后出现淀粉酶及脂肪酶轻度升高,治疗后很快恢复正常。结论 EUS-FNA是病理学诊断胰腺占位性病变安全而有效的方法,应作为首选。Objective Endoscopic ultrasound-guided fine needle aspiration（EUS-FNA）has become a widely accepted effective modality for obtaining tissue for primary diagnosis of the pancreatic lesions.The aim of this paper is to report our initial experience of this procedure for 35 patients with space-occupying lesion of the pancreas.Methods We retrospectively reviewed the data on 35 EUS-FNA procedures performed in 35 patients for evaluation of the space-occupying lesion of the pancreas detected by CT scanning,ultrasonography or clinically suspected diagnosis.The sensitivity,accuracy and safety of EUS-FNA were evaluated.Final diagnosis was based on histological and cytological evidence or on follow-up.Results All these 35 patients with pancreatic lesions were detected by EUS,however 20 patients and 29 patients were detected by transabdominal ultrasonography or CT scanning,respectively.A total of 35 EUS-FNAs were performed during the study period,and the diagnosis was made in 23 cases of pancreatic cancer,9 cases of pancreatitis,1 case of intraductal papillary mucinous neoplasm（IPMN）,1 case of pancreatic pseudocyst,and 1 case of serous cystadenoma.The sensitivity and accuracy of EUS-FNA for suspected pancreatic cancer were 73.91%and 82.86%,respectively.After EUS-FNA,5 patients developed acute mild pancreatitis,and recovered soon following the treatment.Conclusion Our experience confirms that EUS-FNA is a safe and valuable diagnostic method in patients with suspected space-occupying lesion of the pancreas.This technique should be considered the preferred test when a pathological diagnosis of a pancreatic lesion is required.

关 键 词：胰腺占位病变 超声内镜 细针穿刺 病理学 

分 类 号：R735.9[医药卫生—肿瘤]