Department of Gastroenterology, Osaka City University Graduate School of Medicine, 1-4-3, Asahimachi, Abeno-ku, Osaka, 545-8585, Japan.
Clin J Gastroenterol. 2020 Dec;13(6):1367-1372. doi: 10.1007/s12328-020-01167-8. Epub 2020 Jun 29.
Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is safe and useful for the diagnosis of pancreatic cancer. However, sometimes a diagnosis cannot be established by EUS-FNAB. The efficacy of serial pancreatic juice aspiration cytological examination (SPACE) for pancreatic cancer was reported. SPACE may be useful in cases in which diagnosis by EUS-FNAB is difficult; however, this has not been reported previously. We herein report two cases of pancreatic cancer diagnosed by SPACE when diagnosis by EUS-FNAB was difficult. Case 1 was a 77-year-old female. She was suspected of pancreatic cancer because of new-onset diabetes. We performed EUS-FNAB to the lesion in the pancreatic body; however, diagnosis failed. We performed SPACE and diagnosed pancreatic cancer finally. Case 2 was 72 years old female. She was suspected of having pancreatic cancer because of the dilatation of the pancreatic duct. We performed EUS-FNAB twice to the lesion in the pancreatic head, however, diagnosis failed. Therefore, we performed SPACE and got final diagnosis as pancreatic cancer. From our experience, we suggest that SPACE is a useful diagnostic method for patients with pancreatic cancer that are difficult to diagnose.
内镜超声引导下细针抽吸活检（EUS-FNAB）对于胰腺癌的诊断是安全且有用的。然而，有时 EUS-FNAB 无法做出明确诊断。已有研究报道了连续胰腺液抽吸细胞学检查（SPACE）在胰腺癌诊断中的作用。在 EUS-FNAB 诊断困难的情况下，SPACE 可能有用；然而，这尚未见报道。我们在此报告两例 EUS-FNAB 诊断困难的胰腺癌病例，通过 SPACE 诊断。病例 1 为 77 岁女性。由于新发糖尿病，怀疑患有胰腺癌。我们对胰体病变进行了 EUS-FNAB；然而，诊断失败。我们进行了 SPACE，最终诊断为胰腺癌。病例 2 为 72 岁女性。由于胰管扩张，怀疑患有胰腺癌。我们对胰头部病变进行了两次 EUS-FNAB，但诊断失败。因此，我们进行了 SPACE，最终诊断为胰腺癌。根据我们的经验，我们建议对于诊断困难的胰腺癌患者，SPACE 是一种有用的诊断方法。
