胰腺囊性肿瘤诊断进展及评价  

Diagnostic development and evaluation for pancreatic cystic neoplasms

作　　者：张太平[1] 冯梦宇 曹喆[1] 赵玉沛[1] ZHANG Tai-ping;FENG Meng-yu;CAO Zhe;et al.(Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China)

机构地区：[1]中国医学科学院北京协和医院基本外科,北京100730

出　　处：《中国实用外科杂志》2018年第7期749-753,共5页Chinese Journal of Practical Surgery

摘　　要：随着多个学科快速发展和诊断技术不断进步,胰腺囊性肿瘤的检出率明显增加。不同的病变类型其恶变风险不同,尤其对于恶变风险较低的肿瘤,应注意严格把握手术指征。胰腺囊性肿瘤的良恶性鉴别及手术适应证的选择已成为近年来研究的热点。目前,胰腺囊性肿瘤的诊断主要依靠影像学检查,而传统的影像学检查手段(CT、MRI等)尚无法准确区分肿瘤的类型和良恶性。因此,近年来涌现了一系列新技术和新方法用于评估肿瘤类型和鉴别良恶性,如激光共聚焦显微内镜、超声内镜下超声造影和胆道子母镜光纤系统、正电子发射断层显像、纹理分析技术及碎片分析技术、基因突变检测,为指导胰腺囊性肿瘤的诊断和治疗提供了依据。然而,新技术、新方法在诊断灵敏度和特异度方面尚存争议,仍须联合多学科多中心开展进一步研究证实其有效性和安全性。With the continuous development of multidisciplinary team and diagnostic technology,the detection rate of pancreatic cystic neoplasms is increasing significantly. Different lesion types show different risk of malignant transformation,and we should pay attention to the decision of surgical indications especially for the tumor with a lower risk of malignant transformation. Therefore,the identification of benign and malignant pancreatic cystic neoplasms and the selection of surgical indications have become the research hotspot. Current clinical guidelines for pancreatic cystic neoplasms indicate that the diagnosis of pancreatic cystic neoplasms mainly depends on imaging examinations. Traditional imaging examinations （CT,MRI,etc.） are unable to accurately distinguish the type of tumor and identify between benign and malignant. Therefore,a series of new diagnostic technology for assessing lesion types and identification of benign and malignant tumor have been carried out by multidisciplinary team including imaging medicine,digestive endoscopy and nuclear medicine. These new technologies will provide support for the diagnosis and treatment of pancreatic cystic neoplasms. However,the effectiveness and safety of new technologies should be confirmed by further multidisciplinary and multicenter research owing to the controversy on the diagnosis sensitivity and specificity.

关 键 词：胰腺囊性肿瘤 诊断策略 新技术 

分 类 号：R6[医药卫生—外科学]