Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy.
Gastroenterology and Digestive Endoscopy Unit, The Pancreas Institute, University of Verona, G.B. Rossi University Hospital, 11 P.le L.A. Scuro 10, Verona 37134, Italy.
Hepatobiliary Pancreat Dis Int. 2018 Feb;17(1):70-74. doi: 10.1016/j.hbpd.2018.01.010. Epub 2018 Jan 31.
Early detection of small solid pancreatic lesions is increasingly common. To date, few and contradictory data have been published about the relationship between lesion size and endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnostic yield. The aim of this study was to assess the relation between the size of solid pancreatic lesions and the diagnostic yield of EUS-FNA using a 25-gauge needle in a center without available rapid on-site evaluation.
In the retrospective cohort study, we selected patients who underwent EUS-FNA for solid pancreatic lesions with a 25-gauge needle from October 2014 to October 2015. Patients were divided into three groups (≤15 mm, 16-25 mm and >25 mm), and the outcomes were compared.
We analyzed 163 patients. Overall adequacy, sensitivity, specificity and accuracy were 85.2%, 81.8%, 93.7%, and 80.4%, respectively. When stratified by size, the sensitivity and accuracy correlated with size (P = 0.016 and P = 0.042, respectively). Multivariate analysis showed that lesion size was the only independent factor (P = 0.019, OR = 4.76) affecting accuracy. The role of size as an independent factor affecting accuracy was confirmed in a separate multivariate analysis, where size was included in the model as a covariate (P = 0.018, OR = 1.08).
Our study demonstrates that, in the absence of rapid on-site evaluation, mass size affects the accuracy of EUS-FNA of solid pancreatic lesions.
早期发现小的胰腺实体病变越来越常见。迄今为止，关于病变大小与内镜超声引导下细针抽吸术（EUS-FNA）诊断率之间的关系，发表的数据很少且相互矛盾。本研究的目的是评估在没有快速现场评估的情况下，使用 25G 针进行 EUS-FNA 时，胰腺实体病变的大小与 EUS-FNA 诊断率之间的关系。
在这项回顾性队列研究中，我们选择了 2014 年 10 月至 2015 年 10 月期间因胰腺实体病变而接受 25G 针 EUS-FNA 的患者。将患者分为三组（≤15mm、16-25mm 和>25mm），并比较各组的结果。
我们分析了 163 例患者。总体充分性、敏感性、特异性和准确性分别为 85.2%、81.8%、93.7%和 80.4%。按大小分层时，敏感性和准确性与大小相关（P=0.016 和 P=0.042）。多变量分析显示，病变大小是唯一影响准确性的独立因素（P=0.019，OR=4.76）。在单独的多变量分析中，进一步证实了大小作为影响准确性的独立因素的作用，其中大小作为协变量纳入模型（P=0.018，OR=1.08）。
本研究表明，在没有快速现场评估的情况下，肿块大小会影响 EUS-FNA 对胰腺实体病变的准确性。
