胰头部肿块术中组织芯活检临床价值  

Clinical application of core needle biopsy for pancreatic head mass

作　　者：夏菁[1] 陈坚[1] 徐天放[1] 

机构地区：[1]南京医科大学附属苏州市立医院东区普外科,苏州215001

出　　处：《肝胆胰外科杂志》2011年第5期377-378,381,共3页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的评价胰头部肿块术中组织芯活检的定性诊断价值。方法对11年间行胰头部肿块术中组织芯活检245例患者的结果,结合手术后病理切片,进行比较和分析。结果全组患者术中组织芯活检诊断结果示:胰头腺癌188例(76.7%),慢性胰腺炎39例(15.9%)、胰腺不典型增生8例(3.3%)、胰腺神经内分泌肿瘤10例(4.1%)。有3例(1.2%)假阴性的患者,无假阳性病例。穿刺活检敏感性(与术后病理诊断符合率)高达98.8%,特异性为100%。2例(0.8%)发生并发症,其中1例活检过程中因损伤血管导致胆总管出血,病理提示为腺癌,遂行胰十二指肠切除术;另1例慢性胰腺炎行胆肠内引流术,穿刺后引发急性胰腺炎,经非手术治疗后痊愈。结论胰头部肿块术中组织芯活检是判断胰头部肿块性质较为安全、有效而准确的方法,与术后病理切片诊断符合率极高,可以为手术决策提供可靠依据。Objective To evaluate the clinical value of core needle biopsy in the qualitative diagnosis of pancreatic head mass.Methods A total of 245 Core needle biopsies were performed in patients with pancreatic head mass during 11-year period.The histopathological diagnosis on core needle biopsy was then compared with that of excision biopsy.Results In all cases in whom core needle biopsy was the diagnostic procedure,there were 188 cases of pancreatic head cancer（76.7%）,39 cases of chronic pancreatitis（15.9%）,8 cases of pancreatic dysplasia（3.3%）,and 10 cases of pancreatic neuroendocrine tumor（4.1%）;3 cases（1.2%） were false negative,but the false positive rate was zero.The sensitivity of core needle biopsy was 98.8%,with a specificity of 100%.2 cases（0.8%） had complications.One case complicated with bile duct bleeding due to the injury of blood vessel and this complication was treated with pancreaticoduodenectomy.Another case of chronic pancreatitis with biliary drainage complicated with acute pancreatitis and was recovered after conservative therapy.Conclusion The core needle biopsy is safe,efficient,and accurate method in the diagnosis of the pancreatic head mass.It is in good agreement with the pathological diagnosis after surgery.And thus core needle biopsy can provide reliable evidence for surgical decision-making.

关 键 词：胰头部肿块 病理学 活检 诊断 价值 

分 类 号：R735.9[医药卫生—肿瘤]