Department of Gastroenterolgy, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey.
J Dig Dis. 2013 Mar;14(3):132-9. doi: 10.1111/1751-2980.12014.
The aim was to compare the use of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in cytology and the biochemical analysis of cyst fluid, together with the size of the lesion in the differentiation between benign and malignant pancreatic cystic lesions.
Data of patients who underwent EUS-FNA for pancreatic cystic lesions in our center from January 2006 to October 2010 were retrospectively analyzed. The diagnostic accuracy of EUS-FNA was determined.
Of the 56 patients, 37 (66.1%) had evaluable cytology for diagnosis and sufficient cyst fluid was available for biochemical analysis in 58.9% (33/56) of the patients. The sensitivity, specificity, positive predictive value and negative predictive value of EUS-FNA for detecting malignancy were 63%, 100%, 100% and 85%, respectively. EUS-FNA was the most accurate diagnostic method for differentiating malignant and benign pancreatic cystic lesions (88%). Cyst fluid carcinoembryonic antigen (CEA) > 365 ng/mL had a sensitivity of 100% for the detection of malignant cystic lesions.
Although the rate of insufficient cyst fluid aspiration is high, the combination of cytological evaluation and CEA analysis of cyst fluid obtained by EUS-FNA is accurate in differentiating malignant cystic lesions from benign ones. Safe techniques are essential to improve the yield of cyst fluid aspiration by EUS.
旨在比较内镜超声引导下细针抽吸术（EUS-FNA）在细胞学和囊液生化分析中的应用，以及病变大小在鉴别胰腺囊性病变良恶性中的作用。
回顾性分析 2006 年 1 月至 2010 年 10 月在我中心行 EUS-FNA 检查的胰腺囊性病变患者资料，确定 EUS-FNA 的诊断准确性。
56 例患者中，37 例（66.1%）细胞学可评估用于诊断，56 例患者中有 33 例（58.9%）获得足够的囊液用于生化分析。EUS-FNA 检测恶性肿瘤的敏感性、特异性、阳性预测值和阴性预测值分别为 63%、100%、100%和 85%。EUS-FNA 是鉴别胰腺囊性良恶性病变最准确的诊断方法（88%）。囊液癌胚抗原（CEA）＞365ng/mL 对恶性囊性病变的检出具有 100%的敏感性。
尽管抽吸的囊液量不足的发生率较高，但 EUS-FNA 获得的细胞学评估和囊液 CEA 分析相结合，可准确地区分恶性和良性囊性病变。安全的技术对于提高 EUS 抽吸囊液的产量至关重要。
