Yusoff I F, Mendelson R M, Edmunds S E J, Ramsay D, Cullingford G L, Fletcher D R, Zimmerman A M J
Faculty of Dentistry and Medicine, University of Western Australia, Australia.
Abdom Imaging. 2003 Jul-Aug;28(4):556-62. doi: 10.1007/s00261-002-0072-9.
Endoscopic ultrasound (EUS) has been regarded as the most accurate modality for locoregional staging of pancreatic malignancy. However, several recent studies have questioned this. The current study assessed the accuracy of EUS in determining preoperative resectability of pancreatic neoplasia.
A retrospective review was performed of patients with pancreatic malignancy who had preoperative EUS and underwent surgery. EUS-predicted resectability was compared with surgical resectability. Where available, accuracies of vascular and nodal staging were also assessed.
Forty-five patients were identified (mean age 60 years, age range = 36-79 years). All patients underwent surgical exploration; vascular staging was available in 32 cases and 17 cases underwent surgical resection. The sensitivity, specificity, and accuracy of EUS in determining unresectability were 66%, 100%, and 78% respectively. Overall EUS stage concurred with surgical stage in 56%, greater than surgical stage in 4%, and less than surgical stage in 40%. Vascular staging on EUS had a sensitivity of 69% and a specificity of 100%. Accuracy of nodal staging was 71%.
EUS had a high specificity for assessing unresectable pancreatic malignancy. This technique should be used to avoid unnecessary surgical exploration of incurable lesions. However, EUS had only a moderate sensitivity, and a proportion of patients staged preoperatively as having resectable disease will not be surgically resectable.
超声内镜（EUS）一直被认为是胰腺恶性肿瘤局部区域分期最准确的方法。然而，最近的几项研究对此提出了质疑。本研究评估了EUS在确定胰腺肿瘤术前可切除性方面的准确性。
对术前接受EUS检查并接受手术的胰腺恶性肿瘤患者进行回顾性研究。将EUS预测的可切除性与手术可切除性进行比较。在可行的情况下，还评估了血管和淋巴结分期的准确性。
共纳入45例患者（平均年龄60岁，年龄范围36 - 79岁）。所有患者均接受了手术探查；32例患者有血管分期，17例患者接受了手术切除。EUS在确定不可切除性方面的敏感性、特异性和准确性分别为66%、100%和78%。总体而言，EUS分期与手术分期相符的占5&%，高于手术分期的占4%，低于手术分期的占40%。EUS的血管分期敏感性为69%，特异性为100%。淋巴结分期的准确性为71%。
EUS在评估不可切除的胰腺恶性肿瘤方面具有较高的特异性。该技术应用于避免对无法治愈的病变进行不必要的手术探查。然而，EUS的敏感性仅为中等，一部分术前分期为可切除疾病的患者实际上无法进行手术切除。
原文中“总体而言，EUS分期与手术分期相符的占5&%”这里应该是56%，译文已修正。
