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内镜超声鉴别胰腺黏液性囊性肿瘤和浆液性囊性肿瘤的新标准:41例患者的初步确诊结果

New criteria to differentiate between mucinous cystic neoplasm and serous cystic neoplasm in pancreas by endoscopic ultrasound: A preliminarily confirmed outcome of 41 patients.

作者信息

Zhang Wengang, Linghu Enqiang, Chai Ningli, Li Huikai

机构信息

Department of Gastroenterology, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Endosc Ultrasound. 2017 Mar-Apr;6(2):116-122. doi: 10.4103/eus.eus_8_17.

Abstract

BACKGROUND AND OBJECTIVES

The ability to distinguish between mucinous cystic neoplasm (MCN) and serous cystic neoplasm (SCN) in the pancreas preoperatively by endoscopic ultrasound (EUS) remains a clinical challenge. To address this problem, we have developed new criteria using EUS findings and cyst fluid carcinoembryonic antigen (CEA) in the clinic. In this study, the validity and reliability of these criteria were assessed.

MATERIALS AND METHODS

Between April of 2015 and May of 2016, a total of 59 patients with pancreatic cystic neoplasms underwent EUS and ultimately received surgery in our hospital. Of the 59 patients, 21 were pathologically verified to have MCN while 20 were verified to have SCN in the pancreas. For these 41 patients with MCN or SCN, EUS findings and cyst fluid CEA were reviewed.

RESULTS

For the 41 patients reviewed, the new criteria were found to identify MCN with 85.71% sensitivity (95% confidence interval [CI], 64%-97%), 80.00% specificity (CI, 56%-94%), and 82.93% accuracy (CI, 68%-93%).

CONCLUSION

These new criteria were preliminarily found to produce excellent results, with 82.93% accuracy determined for the differential diagnosis between MCN and SCN by EUS. However, a further prospective study with a larger population must be carried out to fully assess these new criteria.

摘要

背景与目的

术前通过内镜超声(EUS)鉴别胰腺黏液性囊性肿瘤(MCN)和浆液性囊性肿瘤(SCN)的能力仍然是一项临床挑战。为解决这一问题,我们在临床中利用EUS检查结果和囊液癌胚抗原(CEA)制定了新的标准。在本研究中,对这些标准的有效性和可靠性进行了评估。

材料与方法

2015年4月至2016年5月期间,共有59例胰腺囊性肿瘤患者在我院接受了EUS检查并最终接受了手术。在这59例患者中,21例经病理证实患有MCN,20例经病理证实胰腺患有SCN。对这41例患有MCN或SCN的患者的EUS检查结果和囊液CEA进行了回顾性分析。

结果

对于所回顾的41例患者,发现新的标准鉴别MCN的灵敏度为85.71%(95%置信区间[CI],64%-97%),特异度为80.00%(CI,56%-94%),准确度为82.93%(CI,68%-93%)。

结论

初步发现这些新标准产生了优异的结果,通过EUS鉴别MCN和SCN的准确度为82.93%。然而,必须开展一项纳入更多人群的进一步前瞻性研究,以全面评估这些新标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c7/5418964/45021fefe48c/EUS-6-116-g001.jpg

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