Sarah C. Upham Division of Gastroenterology and Hepatobiliary diseases, New York Medical College, Valhalla, New York, USA.
Gastrointest Endosc. 2010 Jun;71(7):1185-93. doi: 10.1016/j.gie.2009.12.006. Epub 2010 Mar 20.
Pancreatic neuroendocrine tumors (PNTs) are rare tumors with malignant potential. EUS and EUS-guided FNA (EUS-FNA) have been shown to be superior to other imaging methods in the preoperative localization and diagnosis of PNTs.
To evaluate the clinical presentation, EUS morphology, and sensitivity of EUS-FNA cytology in a large consecutive cohort with histologically and/or cytologically confirmed PNTs.
Retrospective study of all consecutive patients from July 1995 to November 2006 who underwent EUS for a known or suspected PNT and had a subsequently histologically confirmed PNT.
Tertiary referral center.
Ninety-two patients with suspected PNT.
EUS evaluation with or without EUS-FNA of PNTs.
Clinical and EUS features of PNTs and sensitivity of EUS-FNA for the diagnosis of PNTs.
Ninety-two patients underwent EUS; 76 patients had confirmed histopathology, of whom 69 (91%) were symptomatic. Patients with functional PNTs presented with diarrhea, peptic ulcer disease, and hypoglycemia. Tumor locations and echogenic features were similar except that nonfunctional PNTs tended to be larger and have cystic features. Patients with malignant PNTs were older (P = .03), presented with abdominal pain, and had larger tumors (P = .0006) with irregular margins. Eighty-nine percent of patients underwent EUS-FNA. Sensitivity of EUS-FNA for the diagnosis of a PNT was 87%. Sensitivity of EUS-FNA was similar in functional and nonfunctional PNTs. The sensitivity of EUS-FNA was higher for malignant PNTs (P = .008).
Retrospective single tertiary center.
EUS and EUS-FNA are sensitive tools, especially in cases of suspected symptomatic PNTs in which other imaging modalities have failed.
胰腺神经内分泌肿瘤（PNTs）是一种具有恶性潜能的罕见肿瘤。超声内镜（EUS）和 EUS 引导下细针抽吸活检（EUS-FNA）已被证明在 PNTs 的术前定位和诊断方面优于其他影像学方法。
评估一组经组织学和/或细胞学证实的连续大样本胰腺神经内分泌肿瘤患者的临床表现、EUS 形态和 EUS-FNA 细胞学的敏感性。
回顾性研究 1995 年 7 月至 2006 年 11 月期间因已知或疑似 PNT 而行 EUS 检查并随后经组织学证实为 PNT 的所有连续患者。
三级转诊中心。
92 例疑似 PNT 患者。
EUS 评估伴或不伴 EUS-FNA 对 PNTs 的检查。
PNTs 的临床和 EUS 特征以及 EUS-FNA 对 PNTs 诊断的敏感性。
92 例患者行 EUS 检查；76 例患者获得了明确的组织病理学结果，其中 69 例（91%）有症状。功能性 PNTs 患者表现为腹泻、消化性溃疡病和低血糖。肿瘤位置和回声特征相似，但无功能性 PNTs 倾向于更大且具有囊性特征。恶性 PNTs 患者年龄更大（P =.03），表现为腹痛，且肿瘤更大（P =.0006），边缘不规则。89%的患者行 EUS-FNA。EUS-FNA 对 PNT 的诊断敏感性为 87%。功能性和无功能性 PNTs 的 EUS-FNA 敏感性相似。恶性 PNTs 的 EUS-FNA 敏感性更高（P =.008）。
回顾性单中心研究。
EUS 和 EUS-FNA 是敏感的工具，特别是在其他影像学方法失败的疑似有症状 PNTs 病例中。
