Department of Epidemiology and Public Health, Miller School of Medicine, University of Miami, Miami, FL 33136, USA.
Gastrointest Endosc. 2011 Feb;73(2):267-74. doi: 10.1016/j.gie.2010.10.029.
EUS-guided celiac plexus neurolysis (EUS-CPN) improves pain control in patients with pancreatic cancer. EUS allows visualization of the celiac ganglion.
To determine predictors of response to EUS-CPN in a cohort of 64 patients with pancreatic malignancy.
Retrospective analysis of prospective database.
Academic medical center.
Sixty-four patients with pancreatic cancer referred for EUS between March 2008 and January 2010.
EUS-CPN injected directly into celiac ganglia when visible by linear EUS or bilateral injection at the celiac vascular trunk.
Predictors of pain improvement at week 1 by univariate and multivariate analysis.
At week 1, 32 patients (50%) had a symptomatic response. In a multivariate model with 8 potential predictors, visualization of the ganglia was the best predictor of response; patients with visible ganglia were >15 times more likely to respond (odds ratio 15.7; P<.001). Tumors located outside the head of the pancreas and patients with a higher baseline pain level were weakly associated with a good response.
Retrospective design and lack of blinding.
Visualization of celiac ganglia with direct injection is the best predictor of response to EUS-CPN in patients with pancreatic malignancy.
EUS 引导的腹腔神经丛松解术（EUS-CPN）可改善胰腺癌患者的疼痛控制。EUS 可使腹腔神经节可视化。
在 64 例胰腺恶性肿瘤患者的队列中，确定 EUS-CPN 反应的预测因素。
前瞻性数据库的回顾性分析。
学术医疗中心。
64 例于 2008 年 3 月至 2010 年 1 月期间因 EUS 而转介的胰腺癌患者。
当线性 EUS 可见时，将 EUS-CPN 直接注射到腹腔神经节中，或者在腹腔血管干处进行双侧注射。
通过单变量和多变量分析确定第 1 周疼痛改善的预测因素。
第 1 周时，32 例患者（50%）有症状缓解。在有 8 个潜在预测因素的多变量模型中，神经节的可视化是反应的最佳预测因素；可见神经节的患者反应可能性高 15 倍以上（优势比 15.7；P<.001）。肿瘤位于胰头外和基线疼痛水平较高的患者与良好反应呈弱相关。
回顾性设计和缺乏盲法。
在胰腺恶性肿瘤患者中，用直接注射法可视化腹腔神经节是 EUS-CPN 反应的最佳预测因素。
