经超声内镜引导下细针穿刺确诊的11例胰腺转移性肿瘤的临床分析  

Clinical analysis of 11 cases with pancreatic metastatic tumor diagnosed by endoscopic ultrasound-guided fine-needle aspiration

作　　者：满翔 金晶 金震东 吕顺莉 陈颖 Man Xiang;Jin Jing;Jin Zhendong;Lyu Shunli;Chen Ying(Department of Radiology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Gastroenterology,First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院放射诊断科,上海200433 [2]海军军医大学第一附属医院消化内科,上海200433

出　　处：《中华胰腺病杂志》2023年第6期425-430,共6页Chinese Journal of Pancreatology

摘　　要：目的分析胰腺转移性肿瘤的临床特征,评估经超声内镜引导下细针穿刺或活检术(EUS-FNA/B)对其诊断的临床价值。方法回顾性分析2011年1月至2020年12月间海军军医大学第一附属医院经EUS-FNA/B确诊的11例胰腺转移性肿瘤的临床、影像学及病理资料,记录患者的肿瘤大小、病灶数目、转移病灶距离原发灶诊断的时间间隔、影像学及EUS征象、病理类型等,分析EUS-FNA/B成功率及诊断率。结果11例胰腺转移性肿瘤患者年龄43~76岁,男性7例,女性4例;8例首发症状为腹痛、纳差,1例颈部淋巴结肿大,2例常规体检发现;5例血清肿瘤标志物异常。所有患者均有明确的原发肿瘤病史,胰腺转移病灶距原发肿瘤确诊的中位时间间隔为24个月(-1~124个月)。EUS显示7例为单发性占位,4例为多发性结节。8例临床首次诊断为胰腺占位或胰腺肿瘤,3例考虑为胰腺转移性肿瘤。11例经EUS-FNA/B均获得组织条,经组织病理学检查均确诊为胰腺转移性肿瘤,病理类型以肺小细胞神经内分泌癌为主(4例),其次为肾细胞癌(3例),食管鳞状细胞癌、肺鳞状细胞癌、恶性黑色素瘤和胃腺癌各1例。结论胰腺不是肿瘤转移的常见靶器官,EUS-FNA/B是确诊胰腺转移性肿瘤安全性较高的微创手段。Objective To analyze the characteristics of pancreatic metastatic tumors and evaluate the clinical value of endoscopic ultrasound-guided fine-needle aspiration or biopsy(EUS-FNA/B)in their diagnosis.Methods A retrospective analysis was conducted on clinical,radiological,and pathological data of 11 cases with pancreatic metastatic tumors diagnosed by EUS-FNA/B at the First Affiliated Hospital of Naval Medical University between January 2011 and December 2020.Tumor size,number of lesions,time interval between diagnosis of metastatic lesions and primary tumors,radiological and EUS findings and pathological types were recorded,and success rate and diagnostic rate of EUS-FNA/B were analyzed.Results The 11 patients with pancreatic metastatic tumors had an age range of 43 to 76 years,including 7 males and 4 females.Eight cases presented with symptoms of abdominal pain and poor appetite,1 case had cervical lymph node enlargement,and 2 cases were detected during routine physical examination.Five cases had abnormal serum tumor markers.All patients had a confirmed history of primary tumors,and the median time interval between diagnosis of pancreatic metastatic lesions and primary tumors was 24 months(-1-124 months).Seven cases had solitary lesions,and 4 cases had multiple nodules under EUS.Eight cases were initially diagnosed clinically as pancreatic lesions or tumor,while 3 cases were considered as pancreatic metastatic tumor.All of 11 cases underwent EUS-FNA/B and were histologically confirmed as pancreatic metastatic tumors.The most common pathological type was lung small cell neuroendocrine cancer(n=4),followed by renal cell carcinoma(n=3),and esophageal squamous cell carcinoma(n=1),pulmonary squamous cell carcinoma(n=1),malignant melanoma(n=1),and gastric adenocarcinoma(n=1).Conclusions The pancreas is not a common target site for tumor metastasis.EUS-FNA/B is a relatively safe minimally invasive method for the diagnosis of pancreatic metastatic tumors.

关 键 词：胰腺肿瘤 转移性肿瘤 超声内镜引导下细针穿刺 组织病理诊断 

分 类 号：R735.9[医药卫生—肿瘤]