Sighinolfi Michael, Quan Susan Y, Lee Yvonne, Ibaseta Alvaro, Pham Kimberly, Dua Monica M, Poultsides George A, Visser Brendan C, Norton Jeffery A, Park Walter G
Department of Medicine, Santa Clara Valley Medical Center, San Jose, CA, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Dig Dis Sci. 2017 Mar;62(3):626-632. doi: 10.1007/s10620-017-4460-y. Epub 2017 Jan 23.
The aim of this study was to compare the American Gastroenterological Association guidelines (AGA criteria), the 2012 (Fukuoka criteria), and 2006 (Sendai criteria) International Consensus Guidelines for the diagnosis of advanced pancreatic cystic neoplasms.
All patients who underwent surgical resection of a pancreatic cyst from August 2007 through January 2016 were retrospectively analyzed at a single tertiary academic center. Relevant clinical and imaging variables along with pathology results were collected to determine appropriate classification for each guideline. Advanced pancreatic cystic neoplasms were defined by the presence of either high-grade dysplasia or cystic adenocarcinoma. Diagnostic accuracy was measured by ROC analysis.
A total of 209 patients were included. Both the AGA and Fukuoka criteria had a higher diagnostic accuracy for advanced neoplastic cysts than the Sendai criteria: AGA ROC 0.76 (95% CI 0.69-0.81), Fukuoka ROC 0.78 (95% CI 0.74-0.82), and Sendai ROC 0.65 (95% CI 0.61-0.69) (p < 0.0001). There was no difference between the Fukuoka and the AGA criteria. While the sensitivity was higher in the Fukuoka criteria compared to the AGA criteria (97.7 vs. 88.6%), the specificity was higher in the AGA criteria compared to the Fukuoka criteria (62.4 vs. 58.2%).
In a surgical series of patients with pancreatic cysts, the AGA and Fukuoka criteria had superior diagnostic accuracy for advanced neoplastic cysts compared to the original Sendai criteria.
本研究旨在比较美国胃肠病学会指南（AGA标准）、2012年（福冈标准）和2006年（仙台标准）国际共识指南对晚期胰腺囊性肿瘤的诊断。
对2007年8月至2016年1月在单一三级学术中心接受胰腺囊肿手术切除的所有患者进行回顾性分析。收集相关临床和影像变量以及病理结果，以确定每个指南的适当分类。晚期胰腺囊性肿瘤定义为存在高级别异型增生或囊性腺癌。通过ROC分析测量诊断准确性。
共纳入209例患者。AGA和福冈标准对晚期肿瘤性囊肿的诊断准确性均高于仙台标准：AGA的ROC为0.76（95%CI 0.69-0.81），福冈的ROC为0.78（95%CI 0.74-0.82），仙台的ROC为0.65（95%CI 0.61-0.69）（p<0.0001）。福冈标准和AGA标准之间无差异。虽然福冈标准的敏感性高于AGA标准（97.7%对88.6%），但AGA标准的特异性高于福冈标准（62.4%对58.2%）。
在一组胰腺囊肿手术患者中，与原始仙台标准相比，AGA和福冈标准对晚期肿瘤性囊肿具有更高的诊断准确性。
