Departments of Surgery Gastroenterology, Danbury Hospital, Danbury, CT, USA.
HPB (Oxford). 2011 Jul;13(7):459-62. doi: 10.1111/j.1477-2574.2011.00324.x. Epub 2011 Jun 7.
To assess the role of endoscopic ultrasound (EUS) in the initial evaluation and follow-up of incidental pancreatic cystic lesions (PCL).
Retrospective analysis of patients with incidental PCL on imaging who were evaluated by EUS and had a minimal follow-up of 1 year.
There were 62 patients (40 females and 22 males). The mean patient age was 67.7 years (range, 30-89). The Median follow-up was 24 months (range, 12-72). The mean PCL size was 21.6 mm. In all, 13 patients underwent surgery (20.9%). Diagnosis included a mucinous cystic tumour (7), mucinous adenocarcinoma (2), intraductal papillary mucinous neoplasm (1) and a cystic neuroendocrine tumour (1). The overall malignancy rate among patients who underwent surgery was 15.3% (two patients). The mean carcinoembryonic antigen (CEA) level from PCL fluid analysis was also significantly higher in surgically treated group (7760) vs. the stable group (184.7) vs. the enlarging PCL group (361.1). A CEA level above 192 ng/ml predicted mucinous PCL with a sensitivity of 90%.
EUS with cystic fluid analysis can be successfully used to rule out pancreatic neoplasms and to follow-up incidentally discovered PCL.
评估内镜超声（EUS）在偶然发现的胰腺囊性病变（PCL）的初始评估和随访中的作用。
回顾性分析经 EUS 评估且有至少 1 年随访的偶然发现 PCL 的患者。
共有 62 名患者（40 名女性和 22 名男性）。患者的平均年龄为 67.7 岁（范围，30-89 岁）。中位随访时间为 24 个月（范围，12-72 个月）。平均 PCL 大小为 21.6mm。共有 13 名患者（20.9%）接受了手术。诊断包括黏液性囊腺瘤（7 例）、黏液性腺癌（2 例）、导管内乳头状黏液性肿瘤（1 例）和囊性神经内分泌肿瘤（1 例）。手术患者的总体恶性肿瘤发生率为 15.3%（2 例）。手术治疗组患者的胰腺囊液分析中癌胚抗原（CEA）水平也明显高于稳定组（7760）和增大 PCL 组（361.1）。CEA 水平高于 192ng/ml 可预测黏液性 PCL，其敏感性为 90%。
EUS 联合囊液分析可成功用于排除胰腺肿瘤，并对偶然发现的 PCL 进行随访。
