胰液液基细胞学检查在评估导管内乳头状黏液性肿瘤患者恶性程度方面的疗效。
The efficacy of pancreatic juice cytology with liquid-based cytology for evaluating malignancy in patients with intraductal papillary mucinous neoplasm.
作者信息
Miyamoto Kazuya, Matsumoto Kazuyuki, Kato Hironari, Yoshida Ryuichi, Umeda Yuzo, Inoue Hirohumi, Tanaka Takehiro, Matsumi Akihiro, Saragai Yosuke, Fujii Yuki, Yamazaki Tatsuhiro, Uchida Daisuke, Tomoda Takeshi, Horiguchi Shigeru, Yagi Takahito, Okada Hiroyuki
机构信息
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, 2-5-1 Shikata-cho, Okayama, 700-8558, Japan.
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Science, Okayama, Japan.
出版信息
BMC Gastroenterol. 2020 Sep 29;20(1):319. doi: 10.1186/s12876-020-01465-y.
BACKGROUND
Pancreatic juice cytology (PJC) is a tool for diagnosing malignant intraductal papillary mucinous neoplasm (IPMN); however, the accuracy is insufficient using the conventional method. Liquid-based cytology (LBC) improves the cell recovery rate, and almost all cells can be evaluated. We evaluated the efficacy of PJC with LBC for malignant IPMN.
METHODS
We retrospectively analyzed 90 patients with suspected malignant IPMN who underwent PJC before pancreatectomy. PJC with smear and LBC methods was conducted in 52 patients (between June 2003 to December 2011) and 38 patients (between January 2012 to December 2018). Based on the imaging studies, all of the patients were classified according to the international consensus guidelines for IPMN revised in 2017.
RESULTS
Of the 90 patients, 43 (48%) had malignant IPMN (high-grade dysplasia or invasive carcinoma), and the remaining patients had non-malignant IPMN (intermediate- or low-grade dysplasia). LBC increased the accuracy of PJC for the diagnosis of malignant IPMN (smear method: 56% [29/52] vs. LBC method: 76% [29/38]; P = 0.044). In a multivariate analysis, LBC was a significant factor influencing the accurate diagnosis of PJC (odds ratio: 3.52; P = 0.021). Furthermore, LBC increased the accuracy of PJC for malignant IPMN in patients with worrisome features (smear method: 66% [19/29] vs. LBC method: 93% [14/15]; P = 0.043).
CONCLUSIONS
LBC increases the accuracy of PJC for diagnosing malignant IPMN compared with the conventional smear method.
背景
胰液细胞学检查（PJC）是诊断导管内乳头状黏液性肿瘤（IPMN）的一种工具；然而，使用传统方法时准确性不足。液基细胞学检查（LBC）提高了细胞回收率，几乎所有细胞都能得到评估。我们评估了采用LBC的PJC对恶性IPMN的诊断效能。
方法
我们回顾性分析了90例疑似恶性IPMN且在胰腺切除术前接受PJC检查的患者。52例患者（2003年6月至2011年12月）采用涂片法进行PJC检查，38例患者（2012年1月至2018年12月）采用LBC法进行PJC检查。根据影像学检查，所有患者均按照2017年修订的IPMN国际共识指南进行分类。
结果
90例患者中，43例（48%）患有恶性IPMN（高级别异型增生或浸润性癌），其余患者患有非恶性IPMN（中级别或低级别异型增生）。LBC提高了PJC对恶性IPMN的诊断准确性（涂片法：56%[29/52] 对比LBC法：76%[29/38]；P = 0.044）。在多因素分析中，LBC是影响PJC准确诊断的重要因素（比值比：3.52；P = 0.021）。此外，LBC提高了PJC对具有可疑特征患者的恶性IPMN诊断准确性（涂片法：66%[19/29] 对比LBC法：93%[14/15]；P = 0.043）。
结论
与传统涂片法相比，LBC提高了PJC对恶性IPMN的诊断准确性。
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