内镜超声引导下细针穿刺活检对胰腺占位性病变的诊断价值  

The diagnostic value of endoscopic ultrasonography guided fine needle aspiration for occupying pancreatic lesions

作　　者：范震[1] 张乐[1] 张筱凤[1] 黄平[1] 吕文[1] 王霞[1] 赵幼安[2] 

机构地区：[1]杭州市第一人民医院消化科,360001 [2]山东大学齐鲁医院消化科

出　　处：《中华消化内镜杂志》2016年第12期847-850,共4页Chinese Journal of Digestive Endoscopy

基　　金：浙江省医药卫生骨干人才类计划（2011RCB028）

摘　　要：目的探讨内镜超声引导下细针抽吸术（EUS—FNA）定性诊断胰腺占位性病变的安全性和有效性。方法2011年6月至2014年6月，对62例传统影像学检查提示胰腺实性占位性病变的患者行EUS．FNA检查，总结检查完成情况及并发症发生情况，并以最终诊断（依据EUS—FNA诊断、外科手术及临床随访结果给出最终诊断）作为金标准，统计EUS—FNA定性诊断胰腺占位性病变的准确率、敏感度和特异度。结果62例均成功施行EUS—FNA，每例穿刺3—8次（中位穿刺4．2次），穿刺成功率为100．0％（62／62），取材满意率为90．3％（56／62），所有患者术中及术后未出现发热、感染、出血、穿孔、重症胰腺炎及死亡等情况。以最终诊断（恶性胰腺占位性病变39例、良性23例）为金标准，EUS—FNA定性诊断准确率为88．7％（55／62），其中细胞学诊断准确率为69．4％（43／62），明显高于组织学[30．6％（19／62），P〈0．01]，敏感度为87．2％（34／39），特异度为91．3％（21／23）。结论EUS—FNA定性诊断胰腺占位性病变安全和有效。Objective To evaluate safety and efficacy of EUS-FNA for occupying pancreatic lesions. Methods Data of 62 patients with occupying pancreatic lesions, who underwent EUS-FNA between June 2011 and June 2014, were analyzed for completion and complications, with surgery and clinical follow-up as the golden standard. Accuracy, sensitivity and specificity of EUS-FNA were calculated. Results A total of 62 patients with pancreatic lesions successfully underwent EUS-FNA and median puncture number was 4. 2 （ 3 to 8）. Success rate of puncture was 100% and sampling satisfaction rate was 90. 3%（56/62）. No complications such as fever, infection, bleeding, perforation, severe pancreatitis or death were found. With the final diagnosis as the golden standard（ 39 malignant lesions and 23 benign lesions）, overall diagnostic accuracy of EUS-FNA was 88.7% （55/62）. The cytology diagnostic accuracy was 69.4% （43/62）, significantly higher than that of the tissue pathology of 30. 6% （ 19/62, P〈0. 01 ）. Sensitivity and specificity of the procedure were 87. 2% （34/39） and 91.3% （21/23） respectively. Conclusion EUS-FNA is an effective and safe procedure in diagnosis of occupying pancreatic lesions.

关 键 词：超声检查 胰腺疾病 细胞病理学 组织病理学 细针穿刺 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.9[医药卫生—诊断学] R576[医药卫生—临床医学]