内镜超声（EUS）/内镜超声引导下细针穿刺抽吸活检（EUS-FNA）细胞学检查在实性和囊性胰腺神经内分泌肿瘤中的诊断效能
Diagnostic performance of endoscopic ultrasound (EUS)/endoscopic ultrasound--fine needle aspiration (EUS-FNA) cytology in solid and cystic pancreatic neuroendocrine tumours.
作者信息
Mitra Vikramjit, Nayar Manu K, Leeds John S, Wadehra Viney, Haugk Beate, Scott John, Charnley Richard M, Oppong Kofi W
机构信息
HPB Unit, Freeman Hospital, Newcastle, UK.
Department of Cellular Pathology, Royal Victoria Infirmary, Newcastle, UK.
出版信息
J Gastrointestin Liver Dis. 2015 Mar;24(1):69-75. doi: 10.15403/jgld.2014.1121.vmi.
BACKGROUND AND AIMS
Our study aimed to assess the sensitivity of EUS and EUS-FNA for pancreatic neuro-endocrine tumors (pNETs) and compare performance over two consecutive 4 year 2 month periods, to investigate the comparative performance between solid and cystic pNETs and determine the incremental yield of EUS +/- FNA in individuals with a mass not diagnosed as a pNET after cross-sectional imaging.
METHODS
A retrospective review of a prospectively maintained database was carried out to identify all pNET patients who underwent EUS-FNA between April 2003 and September 2011.
RESULTS
A final diagnosis of solid and cystic pNETs was made in 43 and 10 patients, respectively. Overall, the yield of combined EUS imaging and cytology was significantly higher than that of CT and/or MRI (p< 0.05) across all groups [solid (83.7% vs. 41.8%), cystic (70% vs. 10%) and combined solid-cystic (81.1% vs. 35.8%)]. The yield of combined EUS imaging and cytology was significantly better than EUS imaging alone (p<0.05) in the solid (83.7% vs. 58%) and combined pNET cohort (81.1% vs. 52.8%) of patients. After a non-diagnostic CT and or MRI, EUS/EUS-FNA confirmed pNET in 19 out of 25 patients (76.0%) with solid pNETs and 6 out of 9 patients (66.7%) with cystic pNETs.
CONCLUSION
EUS and EUS-FNA had a significant clinical impact in the 25/34 of cases where pNET was not suspected after initial cross-sectional imaging.
背景与目的
我们的研究旨在评估超声内镜（EUS）及EUS引导下细针穿刺活检（EUS-FNA）对胰腺神经内分泌肿瘤（pNETs）的敏感性，并比较连续两个4年2个月期间的检查性能，研究实性和囊性pNETs之间的比较性能，并确定在横断面成像后未诊断为pNETs的肿块患者中EUS ± FNA的额外诊断率。
方法
对一个前瞻性维护的数据库进行回顾性分析，以确定2003年4月至2011年9月期间接受EUS-FNA的所有pNET患者。
结果
最终分别在43例和10例患者中确诊为实性和囊性pNETs。总体而言，在所有组中，EUS成像和细胞学联合检查的诊断率显著高于CT和/或MRI（p<0.05）[实性（83.7%对41.8%）、囊性（70%对10%）和实性-囊性混合（81.1%对35.8%）]。在实性（83.7%对58%）和实性-囊性混合pNET患者队列（81.1%对52.8%）中，EUS成像和细胞学联合检查的诊断率显著优于单独的EUS成像（p<0.05）。在CT和/或MRI检查未明确诊断后，EUS/EUS-FNA在25例实性pNET患者中的19例（76.0%）和9例囊性pNET患者中的6例（66.7%）中确诊为pNET。
结论
在最初横断面成像后未怀疑pNET的25/34例病例中，EUS和EUS-FNA具有显著的临床影响。
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