超声内镜下细针穿刺活检术对胰腺囊性病变的诊断价值  

Endoscopic ultrasoud-guided fine-needle aspiration biopsy in diagnosis of cystic pancreatic lesions

作　　者：覃山羽[1] 姜海行[1] 李萍[2] 韦柳萍[1] 唐国都[1] 黄杰安[1] 张湘莲[1] 陈志敏[1] 

机构地区：[1]广西医科大学第一附属医院消化内科,南宁530021 [2]广西医科大学第一附属医院病理科,南宁530021

出　　处：《中华消化内镜杂志》2013年第8期433-436,共4页Chinese Journal of Digestive Endoscopy

基　　金：广西自然科学基金（桂科青0728072）

摘　　要：目的探讨超声内镜引导下细针穿刺活检术（EUS—FNA）及细胞块对胰腺囊性病变的诊断价值。方法回顾性分析2010年1月至2012年12月行传统影像学检查（CT、MRI、B超）、EUS—FNA的15例胰腺囊性病变的临床资料，其中8例行液基细胞学（LBC）、细胞块检查。同时，比较4种检查技术在胰腺囊性病变中的诊断价值。结果假性囊肿7例，黏液性囊腺瘤2例，胰腺导管内乳头状黏液瘤（IPMN）1例，胰腺癌3例，囊腺癌2例。传统影像学、EUS—FNA、LBC、细胞块的诊断正确率为53．3％、86．7％、75．0％、100．0％，差异有统计学意义（P〈0．05）。EUS—FNA较单纯传统影像学的灵敏度、特异度、约登指数均高（86．7％、75．0％、0．62与53．3％、58．3％、0．12），细胞块较LBC灵敏度高（100．0％与75．0％）。结论EUS—FNA及细胞块可提高诊断胰腺囊性病变的准确率。Objective To investigate the diagnostic value of endoscopic ultrasonography-guided fine needle aspiration （EUS-FNA） and cell blocks for cystic pancreatic lesions. Methods Clinical data of 15 patients with cystic pancreatic lesions who underwent EUS-FNA from January 2010 to December 2012, in which 8 patients accepted the examination of liquid-based cytology （LBC） and cell blocks, were retrospec- tively reviewed. The patients also accepted CT, MRI and B-ultrasound before EUS-FNA, and the results of 4 examinations were compared. Results Among 15 cystic pancreatic lesions, there were 7 cases of pan- creatic pseudocyst, 2 cases of mueinous cyst adenoma, 1 case of intraductal papillary mucinous neoplasm （IPMN） , 3 cases of pancreatic cancer and 2 cases of cyst adenocarcinoma. The diagnostic accuracy of tradi- tional imaging tests, EUS-FNA, LBC, cell blocks were 53.3%, 86. 7%, 75. 0% and 100. 0% respectively （P 〈 0. 05）. Compared with traditional imaging tests, the sensitivity, specificity, Youden index of EUS- FNA were higher （86. 7% , 75.0% and 0. 62 vs. 53.3% , 58.3% and 0. 12）. The sensitivity of cell blocks examination was higher than that of LBC （ 100. 0% vs. 75.0% ）. Conclusion EUS-FNA and the examina- tion of cell blocks can improve the diagnostic accuracy of pancreatic cystic lesions.

关 键 词：活组织检查 细针 内窥镜超声检查 细胞学技术 胰腺肿瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学]