计算机断层扫描引导经皮细针穿刺活检与超声内镜引导下细针穿刺活检在胰腺肿瘤性病变诊断中的比较观察  

Comparative study of computed tomography-guided percutaneous fine needle aspiration biopsy and endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of pancreatic neoplastic lesions

作　　者：樊涛 宋英杰 程三珍 任小丽 于兆民 夏楠 施梦华 刘佳琪 FAN Tao;SONG Yingjie;CHENG Sanzhen;REN Xiaoli;YU Zhaomin;XIA Nan;SHI Menghua;LIU Jiaqi(Department of Hematology,Hubei Provincial Hospital of Integrated Chinese and Western Medicine,Wuhan 430015,China;Department of General Surgery,the People’s Center Hospital of Three Gorges University,Yichang 443000,China)

机构地区：[1]湖北省中西医结合医院肿瘤血液科,湖北武汉430015 [2]三峡大学人民中心医院普外科,湖北宜昌443000

出　　处：《肿瘤基础与临床》2023年第5期415-420,共6页journal of basic and clinical oncology

基　　金：湖北省卫健委联合基金项目(WJ2019H510)。

摘　　要：目的探讨计算机断层扫描引导经皮穿刺活检(CT-PNB)和超声内镜引导下细针穿刺活检(EUS-FNA)在胰腺肿瘤性病变诊断中的准确性、安全性与材料充分性。方法回顾性分析2016年10月至2019年10月湖北省中西医结合医院和宜昌市第一人民医院因疑似胰腺肿瘤性病变行CT-PNB或EUS-FNA获得病理学诊断的98例患者的临床病理资料,其中行CT-PNB胰腺肿瘤性病变40例,行EUS-FNA胰腺肿瘤性病变58例。结果所有患者均顺利完成活检,CT-PNB组和EUS-FNA组敏感性、特异性、阴阳性预测值、准确性、材料充分性分别为85.00%(34/38)和90.57%(48/53)、100.00%(2/2)和100.00%(5/5)、33.33%(2/6)和50.00%(5/10)、100.00%(48/48)和100.00%(48/48)、90.00%(36/40)和91.38%(53/58)。CT-PNB组和EUS-FNA组获取5分材料标本率分别为82.50%(33/40)和63.79%(37/58),差异有统计学意义(χ^(2)=4.059,P=0.039)。所有患者均无大出血、腹腔感染、胰瘘、肠瘘等严重的主要并发症发生。结论CT-PNB与EUS-FNA在胰腺肿瘤性病变诊断中均可获得满意的病理诊断标本,并发症发生率低,是微创、安全、有效的活检方式,其中CT-PNB在穿刺活检病理材料充分性方面占有优势。Objective To evaluate the accuracy,safety and material adequacy of computed tomography-guided percutaneous fine needle aspiration biopsy(CT-PNB)and endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)in the diagnosis of pancreatic neoplastic lesions.Methods The data of 98 patients with pancreatic tumor underwent CT-PNB or EUS-FNA for pathological diagnosis were retrospectively analyzed from October 2016 to October 2019.CT-PNB was per-formed in 40 patients with pancreatic neoplastic lesions,and EUS-FNA in 58 patients with pancreatic neoplastic lesions.Results All the patients successfully completed biopsy.The sensitivity,specificity,negative predictive value and positive predictive value,accuracy,and material adequacy of the CT-PNB group and EUS-FNA group were 85.00%(34/38)and 90.57%(48/53),100.00%(2/2)and 100.00%(5/5),33.3%(2/6)and 50.00%(5/10),100.00%(48/48)and 100.00%(48/48),90.00%(36/40)and 91.38%(53/58),respectively.The rate of obtaining 5 material samples in CT-PNB group and EUS-FNA group was 90.00%(36/40)and 63.79%(37/58),respectively(χ^(2)=4.059,P=0.039).No major complications occurred in all the patients,such as massive hemorrhage,abdominal infection,pancreatic fistula and intestinal fistula.Conclusion Both CT-PNB and EUS-FNA can obtain satisfactory pathological diagnosis specimens in the pancreatic tumor lesions with low incidence of complications.They are minimally invasive,safe and effective biopsy methods.CT-PNB was superior to EUS-FNA in the adequacy of biopsy materials.

关 键 词：胰腺癌 计算机断层扫描 超声内镜 细针穿刺活检 

分 类 号：R735.9[医药卫生—肿瘤]