Endoscopy Unit, Department of Gastroenterology, ICMDM, IDIBAPS, CIBERehd, Hospital Clínic, Barcelona, Spain.
Dig Liver Dis. 2010 Dec;42(12):877-81. doi: 10.1016/j.dld.2010.07.009. Epub 2010 Sep 1.
The diagnosis of pancreatic cystic lesions is still a challenge.
To prospectively investigate the usefulness and safety of EUS-guided cytology brushing (EUS BR) in the cellular diagnosis of pancreatic cysts.
Cysts >15mm were sampled with a 19G needle. The fluid was aspirated and processed for cytology. The brush was introduced to scrub the cystic wall and processed as standard brushings. Antibiotic prophylaxis was administered. Complications were assessed in the first 24h and 7 days after the procedure.
30 patients were included. In 8 patients the technique failed for technical reasons. EUS BR provided with a cellular diagnosis in 20/22 cases (91%). The EUS BR was superior to the aspirated fluid for detecting diagnostic cells (73% vs. 36%, p=0.08) and mucinous cells (50% vs. 18%, p=0.016). In the 8 patients operated on, the specimen was consistent with EUS BR diagnosis. Three patients (10%) had complications, one of them a subacute retroperitoneal haemorrhage in a patient on anticoagulation therapy who died for complications 1 month later.
EUS BR increases cellular diagnosis of pancreatic cystic lesions as compared with fluid analysis, mainly in mucinous lesions. Its use is not recommended in patients under anticoagulation therapy.
胰腺囊性病变的诊断仍然是一个挑战。
前瞻性研究超声内镜引导下细胞学刷检（EUS BR）在胰腺囊肿细胞诊断中的实用性和安全性。
用 19G 针取样>15mm 的囊肿。抽吸液体并进行细胞学处理。引入刷子擦洗囊壁并按标准刷子处理。给予抗生素预防。在操作后 24 小时和 7 天内评估并发症。
共纳入 30 例患者。8 例因技术原因操作失败。EUS BR 对 20/22 例（91%）提供了细胞学诊断。EUS BR 比抽吸液更能检测到诊断细胞（73%比 36%，p=0.08）和黏液细胞（50%比 18%，p=0.016）。在 8 例接受手术的患者中，标本与 EUS BR 诊断一致。3 例（10%）发生并发症，其中 1 例在抗凝治疗的患者中发生亚急性腹膜后出血，1 个月后因并发症死亡。
与液体分析相比，EUS BR 可提高胰腺囊性病变的细胞诊断率，特别是在黏液性病变中。不建议在接受抗凝治疗的患者中使用。
