超声内镜引导下细针穿刺细胞学检查对胰腺病变的诊断价值  

Diagnostic value of endoscopic ultrasound-guided fine needle aspiration cytology in pancreatic lesions

作　　者：陈柯[1] 王海郦[1] 徐莹[1] 王舒蓓[1] 郁柳[1] 刘倩倩[1] 叶廷军[1] 诸琦[1] 孙蕴伟[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化科,200025

出　　处：《中华消化杂志》2014年第6期392-395,共4页Chinese Journal of Digestion

基　　金：卫生行业科研专项项目（201002020）

摘　　要：目的 探讨超声内镜引导下细针穿刺术（EUS-FNA）细胞学检查对于胰腺占位性疾病的诊断价值.方法 回顾性分析2012年4月至2013年8月间117例因胰腺病变行EUS-FNA细胞学检查的患者的病史资料,最终确诊依据参照病理及随访结果.统计学分析比较采用成组t检验,计数资料比较采用Pearson及CMH卡方检验.结果 经病理检查及随访明确的良恶性病变共95例,其中良性47例,恶性48例.EUS-FNA对于胰腺恶性占位病变的诊断准确度、敏感度、特异度分别为80.00％、70.83％、89.36％.67例患者经细胞学检查明确诊断,其中胰腺实性肿瘤46例,胰腺囊肿15例,其他疾病（如胰腺炎）6例.EUS-FNA细胞学检查对于实性肿瘤诊断准确度、敏感度、特异度分别为80.60％、71.74％、100.00％,对于胰腺囊肿的诊断价值偏低,其准确度、敏感度、特异度分别为73.13％、53.33％、78.85％.结论 EUS-FNA细胞学检查能有效鉴别胰腺良恶性病变,对于胰腺实性肿瘤的诊断价值更高.Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration （EUS-FNA） cytology in pancreatic lesions.Methods From April 2012 to August 2013,the clinical data of 117 patients received EUS FNA cytology examination was retrospectively analyzed,and the final dignosis was according to pathological examination and follow-up results.In statistical analysis,group t test was performed for comparison and Pearson x2 and CMH-x2 test were used for comparison in count data.Results According to pathological examination and follow up,a total of 95 cases were clearly diagnosed as malignant or benign lesion,in which benign lesion accounted for 47 cases and malignant lesion 48 cases.The accuracy,sensitivity and specificity of EUS-FNA cytology in the diagnosis of malignant pancreatic lesions were 80.00％,70.83％ and 89.36％,respectively.Subsequently 67 cases were clearly diagnosed by cytopathology,in which,there were 46 cases of pancreatic solid neoplasms,15 cases of cystic lesions and six cases of others diseases such as pancreatitis.The accuracy,sensitivity and specificity of EUS-FNA cytology in the diagnosis of solid neoplasm were 80.60％,71.74％ and 100.00％,respectively.Nevertheless,for cystic lesions,the diagnosis value was low,the accuracy,sensitivity and specificity of which were 73.13％,53.33％ and 78.85％,respectively.Conclusion Pancreatic malignant and benign lesions can be effectively differentiated by EUS FNA cytology examination and the diagnostic value is of which even higher in pancreatic solid neoplasms.

关 键 词：胰腺疾病 占位性病变 腔内超声检查 活组织检查 细针 细胞学 诊断 

分 类 号：R735.9[医药卫生—肿瘤]