SpyGlass 对胰腺囊性病变的诊断价值：EUS 引导下细针抽吸与 EUS 引导下细针抽吸联合 SpyGlass 的比较。
Diagnostic value of SpyGlass for pancreatic cystic lesions: comparison of EUS-guided fine-needle aspiration and EUS-guided fine-needle aspiration combined with SpyGlass.
机构信息
Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Haidian District, No. 28 of Fuxing Road, Beijing, 100853, China.
出版信息
Surg Endosc. 2022 Feb;36(2):904-910. doi: 10.1007/s00464-021-08347-8. Epub 2021 Mar 1.
BACKGROUND AND AIMS
No study has evaluated the diagnostic value of SpyGlass by comparing SpyGlass results and non-SpyGlass results. In this retrospective study, we aimed to compare the diagnostic value of EUS-guided fine-needle aspiration (EUS-FNA) and EUS-FNA combined with SpyGlass to evaluate whether SpyGlass is valuable for increasing the diagnostic yield of EUS-FNA.
METHODS
From April 2015 to April 2020, 251 patients suspected of having pancreatic cystic lesions (PCLs) by imaging techniques who then underwent EUS-FNA were retrospectively enrolled. Only 98 patients who underwent surgical resection with a pathological diagnosis of pancreatic cystic lesion (PCL) were studied. The diagnostic performance outcomes were compared between the EUS-FNA group (EUS-FNA alone, n = 40) and the SpyGlass group (EUS-FNA combined with SpyGlass, n = 58) to assess the value of SpyGlass in diagnosing PCLs.
RESULTS
There were 71 females and 27 males with an overall mean age of 47.6 years. The median diameter of the PCLs was 42.2 mm (range, 11.4-100.0 mm). Approximately 37 cysts were localized in the head/neck of the pancreas, while 61 in the body/tail. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the EUS-FNA group were 96.4% (27/28), 83.3% (10/12), 93.1% (27/29), 90.9% (10/11) and 92.5% (37/40), while those in the SpyGlass group were 100% (54/54), 75% (3/4), 98.2% (54/55), 100% (3/3) and 98.3% (57/58), respectively. The diagnostic accuracy rate in the SpyGlass group was higher than that in the EUS-FNA group; however, no significant difference was found between the two groups (P = 0.368). The diagnostic accuracy of evaluating specific cyst types in the EUS-FNA group was 85% (34/40), similar to that in the SpyGlass group (85.0% vs 84.5%, P = 0.944).
CONCLUSION
SpyGlass seems less valuable for the diagnosis of PCLs when EUS and EUS-FNA have been performed by experienced endoscopists.
背景与目的
尚无研究通过比较SpyGlass 结果与非 SpyGlass 结果来评估 SpyGlass 的诊断价值。在这项回顾性研究中，我们旨在比较 EUS 引导下细针抽吸（EUS-FNA）和 EUS-FNA 联合 SpyGlass 的诊断价值，以评估 SpyGlass 是否有助于提高 EUS-FNA 的诊断率。
方法
本研究纳入了 2015 年 4 月至 2020 年 4 月期间因影像学技术怀疑患有胰腺囊性病变（PCL）而行 EUS-FNA 的 251 例患者。仅对行手术切除且病理诊断为胰腺囊性病变（PCL）的 98 例患者进行了研究。比较了 EUS-FNA 组（仅行 EUS-FNA，n=40）和 SpyGlass 组（EUS-FNA 联合 SpyGlass，n=58）的诊断性能结果，以评估 SpyGlass 在诊断 PCL 中的价值。
结果
共有 71 名女性和 27 名男性，平均年龄为 47.6 岁。PCL 的中位直径为 42.2mm（范围 11.4-100.0mm）。约 37 个囊肿位于胰头/颈部，61 个位于胰体/尾部。EUS-FNA 组的敏感性、特异性、阳性预测值、阴性预测值和诊断准确率分别为 96.4%（27/28）、83.3%（10/12）、93.1%（27/29）、90.9%（10/11）和 92.5%（37/40），SpyGlass 组分别为 100%（54/54）、75%（3/4）、98.2%（54/55）、100%（3/3）和 98.3%（57/58）。SpyGlass 组的诊断准确率高于 EUS-FNA 组，但两组间无显著差异（P=0.368）。EUS-FNA 组评估特定囊肿类型的诊断准确率为 85%（34/40），与 SpyGlass 组相似（85.0%比 84.5%，P=0.944）。
结论
当经验丰富的内镜医生进行 EUS 和 EUS-FNA 检查时，SpyGlass 对 PCL 的诊断价值似乎较低。
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