Seicean Andrada, Badea Radu, Mocan Teodora, Iancu Cornel, Pop Teodora, Seicean Radu, Mo Scedil Teanu Ofelia, B Abreve L Abreve Ovidiu, Pascu Oliviu
3rd Medical Clinic, Croitorilor Str., 19-21 400162 Cluj-Napoca, Romania.
J Gastrointestin Liver Dis. 2008 Sep;17(3):273-8.
Endoscopic ultrasonography (EUS) is a diagnostic method that aims to detect and stage tumors of the pancreas more accurately. It has a high predictive role regarding tumor resectability.
The present paper aims to assess the diagnostic accuracy of radial EUS in the staging of pancreatic cancer as well as the role of EUS to predict tumor resectability.
30 patients (22 males, 8 females, mean age 61 +/- 12 years) with pancreatic masses staged by both radial EUS and surgery (17 patients with intraoperative exploration and 13 with pathological examination of surgical specimens) and with histologically proved adenocarcinoma were included in the study. Surgical examination was indicated in patients with pancreatic masses evidenced by imaging methods other than EUS, without distant metastases proved preoperatively, and without taking into consideration the staging obtained by EUS. Resectability criteria for pancreatic tumors as assessed by EUS were invasion of superior mesenteric artery or invasion of celiac trunk.
The accuracy of EUS T staging was 86.6%, that of N staging was 93.3% while that of the vascular invasion was 80%. The accuracy of EUS for predicting tumor stage had a direct impact on the assessment of tumor resectability (83.3%, CI 95%: 81.5- 85.2). It had a sensitivity of 100%, specificity of 75%, PPV of 91.6% and NPV of 100%.
The radial EUS of the pancreas is an accurate method for tumor staging. For establishing tumor resectability, association with other imaging methods is advisable for arterial assessment.
内镜超声检查（EUS）是一种旨在更准确地检测和分期胰腺肿瘤的诊断方法。它在肿瘤可切除性方面具有很高的预测作用。
本文旨在评估径向EUS在胰腺癌分期中的诊断准确性以及EUS预测肿瘤可切除性的作用。
本研究纳入了30例胰腺肿块患者（22例男性，8例女性，平均年龄61±12岁），这些患者均接受了径向EUS和手术分期（17例患者进行了术中探查，13例患者进行了手术标本的病理检查），且组织学证实为腺癌。对于通过EUS以外的成像方法证实有胰腺肿块、术前未证实有远处转移且不考虑EUS所获分期的患者，建议进行手术检查。EUS评估胰腺肿瘤可切除性的标准为肠系膜上动脉侵犯或腹腔干侵犯。
EUS T分期的准确性为86.6%，N分期的准确性为93.3%，而血管侵犯的准确性为80%。EUS预测肿瘤分期的准确性对肿瘤可切除性的评估有直接影响（83.3%，95%置信区间：81.5 - 85.2）。其敏感性为100%，特异性为75%，阳性预测值为91.6%，阴性预测值为100%。
胰腺径向EUS是一种准确的肿瘤分期方法。为确定肿瘤的可切除性，建议将其与其他成像方法联合用于动脉评估。
