Institut des Maladies de l'Appareil Digestif. Department of Gastroenterology and Hepatology, University Hospital, Nantes, France.
Aliment Pharmacol Ther. 2009 Nov 15;30(10):1070-7. doi: 10.1111/j.1365-2036.2009.04138.x. Epub 2009 Sep 4.
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is a safe and accurate technique for diagnosing pancreatic cancer. However, its impact for management of these patients is poorly investigated.
To investigate the diagnostic yield and the therapeutic impact of EUS-FNA in the management of solid pancreatic masses.
One hundred consecutive patients who underwent EUS-FNA for a solid pancreatic mass were included. Aspirates were placed onto glass slides for cytological examination and microbiopsies were fixed in formaldehyde for histology. The impact on clinical management was analysed retrospectively according to different endpoints, such as its impact on indications for chemotherapy, surgery or appropriate follow-up modality.
Eight procedures were considered failures and two patients were lost to follow-up. A final diagnosis was obtained in 90 patients. The sensitivity, specificity and accuracy of combined cytology and histology for the diagnosis of malignant or potentially-malignant tumours were 78%, 75%, and 78% respectively. The sensitivity and accuracy of cytology alone were significantly higher than those of histology alone (P = 0.0003). By intention-to-diagnose analysis, EUS-FNA directly influenced the management strategy in 62 of 100 patients.
In patients with pancreatic mass and suspected malignancy, EUS-FNA provides an accurate diagnosis in approximately 80% of cases. EUS-FNA directly influences the management in two-thirds of patients.
内镜超声引导下细针抽吸（EUS-FNA）是一种安全、准确的诊断胰腺癌的技术。然而，其对这些患者的管理影响尚未得到充分研究。
研究 EUS-FNA 在处理实性胰腺肿块中的诊断效果和治疗影响。
连续纳入 100 例因实性胰腺肿块而行 EUS-FNA 的患者。抽吸物置于载玻片上进行细胞学检查，组织活检用甲醛固定进行组织学检查。根据不同的终点（如对化疗、手术或适当的随访方式的指示的影响），回顾性分析对临床管理的影响。
8 例操作被认为是失败的，2 例患者失访。90 例患者获得了最终诊断。联合细胞学和组织学对恶性或潜在恶性肿瘤的诊断的敏感性、特异性和准确性分别为 78%、75%和 78%。细胞学单独的敏感性和准确性显著高于组织学单独的敏感性和准确性（P = 0.0003）。通过意向性诊断分析，EUS-FNA 直接影响了 100 例患者中的 62 例患者的管理策略。
在胰腺肿块和疑似恶性肿瘤的患者中，EUS-FNA 在大约 80%的病例中提供了准确的诊断。EUS-FNA 直接影响了三分之二的患者的管理。
