Edoute Y, Lemberg S, Malberger E
Department of Internal Medicine C, Rambam Medical Center, Haifa, Israel.
Am J Gastroenterol. 1991 Aug;86(8):1015-9.
The aim of the present study was to describe our experience from 1976 through 1988 with fine needle aspiration (FNA) cytology of pancreatic lesions in 90 patients. Fine needle aspirations were performed preoperatively under ultrasound guidance (USG) in 46 patients, under computed tomographic guidance (CTG) in seven patients, and intraoperatively in 37 patients. Based on histologic, cytologic, and clinical findings, final diagnoses were reached in 80 patients, of whom 62 had malignant pancreatic disease (MPD) and 18 had benign pancreatic disease (BPD). The accuracy of cytologic diagnoses was verified by histologic, cytologic, and clinical findings. In 62 patients with MPD, the cytologic findings suggested malignancy in 54 patients, suspected malignancy in five, and did not reveal malignancy in three patients. Among 18 patients with BPD, all of the cytologic findings were reported as benign. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for intraoperative FNA cytologic results were 96%, 100%, 100%, 91%, and 97%, respectively, and for USG FNA cytologic results were 94%, 100%, 100%, 78%, and 95%, respectively. No complications followed the procedure.
Both transabdominal percutaneous imaging-guided and intraoperative FNA cytology of pancreatic lesions are simple, safe, and highly accurate methods in differentiation of benign from malignant pancreatic lesions.
本研究的目的是描述我们在1976年至1988年期间对90例胰腺病变患者进行细针穿刺（FNA）细胞学检查的经验。46例患者在术前超声引导（USG）下进行细针穿刺，7例在计算机断层扫描引导（CTG）下进行，37例在术中进行。根据组织学、细胞学和临床检查结果，80例患者得出了最终诊断，其中62例患有恶性胰腺疾病（MPD），18例患有良性胰腺疾病（BPD）。细胞学诊断的准确性通过组织学、细胞学和临床检查结果得到验证。在62例MPD患者中，细胞学检查结果显示54例为恶性，5例疑似恶性，3例未显示恶性。在18例BPD患者中，所有细胞学检查结果均报告为良性。术中FNA细胞学检查结果的敏感性、特异性、阳性和阴性预测值以及诊断准确性分别为96%、100%、100%、91%和97%，USG FNA细胞学检查结果分别为94%、100%、100%、78%和95%。该操作未引发并发症。
经腹经皮影像引导和术中胰腺病变FNA细胞学检查都是区分胰腺良性和恶性病变的简单、安全且高度准确的方法。
