经皮超声引导下实时18/20G切割针穿刺活检用于早期诊断胰腺肿瘤效果比较  

Comparison of percutaneous ultrasound-guided 18-or 20-gauge trucut needle biopsy in patients with suspected pancreatic carcinoma

作　　者：苏林娜 李涛 周敏 吕海茹 王宪 王建宏 SU Linna;LI Tao;ZHOU Min;LÜHairu;WANG Xian;WANG Jianhong(Ultrasonic Diagnosis and Treatment Center,Xijing Hospital of Digestive Diseases,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京消化病医院超声诊疗中心,西安710032

出　　处：《临床与病理杂志》2021年第5期1081-1087,共7页Journal of Clinical and Pathological Research

摘　　要：目的:经皮超声引导下切割针活检(ultrasound guided trucut needle biopsy,US-TNB)是一种用来诊断胰腺占位性病变的重要方法。然而,哪种切割针用于穿刺效果更优越,既往鲜有研究报道,本研究目的在于比较18/20G切割针用于胰腺占位性病变穿刺诊断的效果。方法:共纳入2009年1月至2017年6月于空军军医大学西京消化病医院超声诊疗中心行超声引导下实时胰腺占位性病变穿刺的患者285例,其中,70例用18G穿刺针,215例用20G穿刺针进行活检。将经皮US-TNB并进行组织病理学诊断的结果与手术后或长期临床随访得出的最终诊断结果相比较。比较两种不同型号穿刺针进行穿刺的成功率、诊断率、准确率、敏感性(sensitiv ity,Se)、特异性(specificity,Sp)、阳性预测值(positive predictive value,PPV)及阴性预测值(negative predictive value,NPV)。结果:18G和20G两组的穿刺成功率均为100%;诊断率分别为91.4%和84.7%,差异没有统计学意义(P>0.05);准确率分别为96.8%和96.7%,差异无统计学意义(P>0.05);Se、Sp、PPV、NPV分别为96.3%、100%、81.3%、18.8%和96.0%、100%、76.9%、23.1%。无严重并发症发生。结论:18G和20G穿刺针进行胰腺占位性病变穿刺活检在诊断率及准确率方面无明显差异,但18G针的穿刺次数更少。Background:Percutaneous ultrasound guided trucut needle biopsy(US-TNB)is an important method for diagnosing pancreatic space-occupying lesions.However,it is uncertainty about which needle size is more suitable.There are few reports in the past.We aimed to evaluate the performance of the 18-and 20-gauge(18G and 20G)types of needle in obtaining histopathological diagnosis of pancreatic space-occupying lesions.Methods:This study included 285 patients(70:18G needle/215:20G needle)who underwent ultrasound-guided real-time puncture of pancreatic space-occupying lesions in the Ultrasonic Center&Xijing Hospital of Digestive Diseases,the Air Force Medical University from January 2009 to June 2017.Two types of needle were compared with respect to technical success rate,diagnostic rate,accuracy,sensitivity(Se),specificity(Sp),positive predictive value(PPV)and negative predictive value(NPV)for histolopathological diagnosis.Results:Percutaneous USTNB histopathological findings were compared with the gold standard of surgical histopathological findings or long-term clinical follow-up.The puncture technical success rate was 100%for both 18G and 20G needle.The diagnostic rate of 18G and 20G were 91.4%and 84.7%respectively,with no significant difference between them(P>0.05).The accuracy of 18G needle was 96.8%and that was 96.7%for 20G needle,the difference was not statistically significant(P>0.05).The Se,Sp,PPV,and NPV were 96.3%,100%,81.3%,and 18.8%for the 18G needle compared with 96.0%,100%,76.9%,and 23.1%respectively for the 20G needle.No serious complications occurred.Conclusion:Current data show no significant difference between the 18G and 20G needle in diagnostic rate and accuracy for the diagnosis of pancreatic space-occupying lesions.However,the 18G needle establishes the diagnosis with fewer puncture times.

关 键 词：超声 胰腺病变 切割针 穿刺 活检 

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]