Ryozawa Shomei, Kitoh Hideaki, Gondo Toshikazu, Urayama Naoki, Yamashita Hiroaki, Ozawa Hirokazu, Yanai Hideo, Okita Kiwamu
Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube 755-8505, Japan.
J Gastroenterol. 2005 Sep;40(9):907-11. doi: 10.1007/s00535-005-1652-6.
Endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) has come into widespread use, mainly in Western countries, as an efficient and safe method for the cytologic or histologic diagnosis of pancreatic cancer. However, it still has received relatively little attention in Japan. To evaluate the clinical status of EUS-FNAB in Japan, we retrospectively analyzed the results with regard to the ability of EUS-FNAB to diagnose pancreatic cancer, as well as its safety.
A total of 52 patients (37 male, 15 female; mean age, 62.5 years; range, 33-85 years) with focal pancreatic lesions underwent EUS-FNAB at our group of hospitals in one region of Japan. Final diagnosis was confirmed by histologic examination of surgical specimens or clinical follow-up.
The final diagnoses were malignant tumors in 32 patients and benign ones in 20. Insertion of the needle into the lesion was successful in 50 of the 52 patients (96.2%). Adequate specimens were obtained by EUS-FNAB from 47 of the 50 pancreatic lesions (94.0%). With five false-negative and no false-positive results, the accuracy, sensitivity, specificity, and positive and negative predictive values were 89.4%, 82.1%, 100%, 100%, and 79.2%, respectively. No complications occurred.
EUS-FNAB is an efficient and safe method for the histologic diagnosis of pancreatic cancer. It should be considered as one of the indispensable modalities for the histological diagnosis of pancreatic cancer in Japan, as it is in Western countries.
内镜超声引导下细针穿刺活检（EUS-FNAB）作为一种高效、安全的胰腺癌细胞学或组织学诊断方法，已在西方国家广泛应用。然而，在日本它仍相对较少受到关注。为评估EUS-FNAB在日本的临床应用情况，我们回顾性分析了EUS-FNAB诊断胰腺癌的能力及其安全性方面的结果。
日本一个地区的一组医院中，共有52例胰腺局灶性病变患者（男性37例，女性15例；平均年龄62.5岁；范围33 - 85岁）接受了EUS-FNAB。最终诊断通过手术标本的组织学检查或临床随访得以证实。
最终诊断为恶性肿瘤的患者有32例，良性肿瘤患者20例。52例患者中有50例（96.2%）穿刺针成功插入病变部位。50例胰腺病变中有47例（94.0%）通过EUS-FNAB获取了足够的标本。假阴性结果5例，无假阳性结果，准确率、敏感度、特异度、阳性预测值和阴性预测值分别为89.4%、82.1%、100%、100%和79.2%。未发生并发症。
EUS-FNAB是一种高效、安全的胰腺癌组织学诊断方法。在日本，它应被视为胰腺癌组织学诊断不可或缺的方法之一，如同在西方国家一样。
