Collins Brian T, Adhikari Laura J, Bernadt Cory T, Wang Jeff F
Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri.
Department of Pathology and Immunology, School of Medicine, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri.
J Am Soc Cytopathol. 2015 Mar-Apr;4(2):74-78. doi: 10.1016/j.jasc.2014.10.003. Epub 2014 Oct 8.
Endoscopic ultrasonography (EUS) is commonly used in the evaluation of pancreas masses, and when a liver lesion is visualized, it can undergo a fine-needle aspiration (FNA). This can provide diagnostic and staging information. The purpose of the study was to correlate the findings of patients who underwent EUS FNA biopsy of a pancreas lesion and a liver lesion during the same procedure.
The pathology database at Washington University Medical Center was searched for EUS FNA biopsy cases where biopsy of both the pancreas and liver were performed over a consecutive 10-year period (2003-2013). All pathology reports were reviewed, and clinical information and diagnostic results were recorded.
A total of 102 cases were identified. For pancreas cases, 79.4% were malignant and for liver cases, 58.8% were malignant. In pancreas lesions categorized as suspicious for malignancy (9%), the liver biopsy provided a diagnosis of malignancy in 67% of cases. A malignant pancreatic cohort demonstrated a 62.9% liver malignancy. A malignant liver cohort corresponded to a malignant pancreas diagnosis in 86.6% of cases and a suspicious-malignant group of 98.3%.
The 102 cases with concomitant EUS FNA biopsy of the pancreas and liver demonstrated the ability to provide a diagnosis of pancreas malignancy and correlate regional metastatic malignancy in the liver. In patients with a pancreas mass and in the appropriate clinical setting, a liver EUS FNA biopsy has the ability to provide a diagnosis of malignancy and demonstrate a high positive predictive value of malignancy in the pancreas (98.3%).
内镜超声检查（EUS）常用于评估胰腺肿块，当观察到肝脏病变时，可对其进行细针穿刺抽吸活检（FNA）。这能够提供诊断和分期信息。本研究的目的是将在同一操作过程中接受胰腺病变和肝脏病变EUS FNA活检的患者的检查结果进行关联。
检索华盛顿大学医学中心病理数据库，查找在连续10年期间（2003 - 2013年）同时进行胰腺和肝脏活检的EUS FNA活检病例。审查所有病理报告，并记录临床信息和诊断结果。
共确定了102例病例。胰腺病例中，79.4%为恶性；肝脏病例中，58.8%为恶性。在归类为可疑恶性的胰腺病变（9%）中，肝脏活检在67%的病例中确诊为恶性。恶性胰腺组中肝脏恶性病变的比例为62.9%。恶性肝脏组在86.6%的病例中与胰腺恶性诊断相符，在可疑恶性组中这一比例为98.3%。
102例同时进行胰腺和肝脏EUS FNA活检的病例表明，该检查能够对胰腺恶性肿瘤作出诊断，并关联肝脏区域的转移性恶性肿瘤。对于有胰腺肿块且处于适当临床背景的患者，肝脏EUS FNA活检能够诊断恶性肿瘤，并在胰腺中显示出较高的恶性阳性预测值（98.3%）。
