内镜超声引导下细针穿刺活检在胰腺肿块评估中的应用
Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses.
作者信息
Harewood Gavin C, Wiersema Maurits J
机构信息
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota 55905, USA.
出版信息
Am J Gastroenterol. 2002 Jun;97(6):1386-91. doi: 10.1111/j.1572-0241.2002.05777.x.
OBJECTIVES
Diagnosis of pancreatic tumors can be problematic. This study aimed to determine the performance of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS FNA) in pancreatic malignancy when prior biopsies performed by CT guidance or ERCP were negative.
METHODS
A total of 185 patients with known or suspected pancreatic masses were prospectively evaluated with EUS FNA. Before EUS FNA, all patients were evaluated with abdominal CT (61 with CT-guided biopsy) and 91 with ERCP (41 had brushings or biopsy).
RESULTS
EUS had greater sensitivity than CT in detecting a mass (99% vs 57%, p < 0.0001). In 58 patients with negative CT-guided biopsies, EUS FNA had 90% sensitivity for malignancy, 50% specificity for benign disease and 84% accuracy. Similarly, in 36 patients with negative ERCP tissue sampling, results for EUS FNA were 94%, 67% and 92%, respectively. Complications were mild and infrequent (0.5%).
CONCLUSION
EUS FNA of pancreatic masses safely and accurately diagnoses pancreatic malignancy when prior biopsy techniques have been unsuccessful.
目的
胰腺肿瘤的诊断可能存在问题。本研究旨在确定当先前由CT引导或ERCP进行的活检为阴性时，内镜超声引导下细针穿刺活检（EUS-FNA）在胰腺恶性肿瘤诊断中的性能。
方法
对185例已知或疑似胰腺肿块的患者进行前瞻性EUS-FNA评估。在进行EUS-FNA之前，所有患者均接受腹部CT检查（61例行CT引导下活检），91例行ERCP检查（41例行刷检或活检）。
结果
EUS在检测肿块方面比CT具有更高的敏感性（99%对57%，p<0.0001）。在58例CT引导下活检为阴性的患者中，EUS-FNA对恶性肿瘤的敏感性为90%，对良性疾病的特异性为50%，准确性为84%。同样，在36例ERCP组织采样为阴性的患者中，EUS-FNA的结果分别为94%、67%和92%。并发症轻微且不常见（0.5%）。
结论
当先前的活检技术未成功时，胰腺肿块的EUS-FNA可安全、准确地诊断胰腺恶性肿瘤。
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