Ishikawa-Kakiya Yuki, Maruyama Hirotsugu, Yamamoto Kei, Yamamura Masafumi, Tanoue Kojiro, Higashimori Akira, Ominami Masaki, Nadatani Yuji, Fukunaga Shusei, Otani Koji, Hosomi Shuhei, Tanaka Fumio, Kamata Noriko, Nagami Yasuaki, Taira Koichi, Shiba Masatsugu, Watanabe Toshio, Fujiwara Yasuhiro
Department of Gastroenterology, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Department of Medical Statistics, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan.
Cancers (Basel). 2021 Mar 11;13(6):1217. doi: 10.3390/cancers13061217.
Endoscopic ultrasonography (EUS) is useful for detecting early-stage pancreatic cancer. Because the detection of small lesions is difficult, it is important to detect indirect findings, namely caliber change, retention cysts, and dilatation of the branch duct, during the procedure. Although two types of EUS endoscopes are frequently used, there is no comparative study on their efficacy for detecting indirect findings. Therefore, we aimed to compare the diagnostic efficacy of these two types for indirect findings. We retrospectively analyzed 316 consecutive patients who had undergone EUS for pancreaticobiliary disease at a single center between January 2017 and December 2018. The main outcome was the detection rate of indirect findings and its comparison between the two echoendoscope types. This outcome was achieved using the inverse probability of treatment weighting (IPTW) analysis. The detection rate of indirect findings was higher for the radial-arrayed endoscope than for the convex-arrayed echoendoscope (9.2% vs. 2.3% ( = 0.02)). The univariate analysis also revealed that the radial-arrayed echoendoscope was significantly superior to the convex-arrayed echoendoscope in terms of the detection of indirect findings (odds ratio, 5.94; 95% confidence interval, 1.68-21.10; = 0.01) after IPTW. After adjustment for magnetic resonance imaging (MRI) and computed tomography (CT), radial-arrayed echoendoscope remained an independent factor for indirect finding detection (odds ratio, 6.04; 95% confidence interval, 1.74-21.00; = 0.01). Finally, five patients who had indirect EUS findings were diagnosed with pancreatic cancer. Our results indicate that the radial-arrayed echoendoscope is useful for the detection of indirect findings.
内镜超声检查（EUS）有助于检测早期胰腺癌。由于检测小病变困难，在检查过程中检测间接征象，即管径改变、潴留性囊肿和分支胰管扩张很重要。虽然经常使用两种类型的EUS内镜，但尚无关于它们检测间接征象效能的比较研究。因此，我们旨在比较这两种类型内镜检测间接征象的诊断效能。我们回顾性分析了2017年1月至2018年12月在单一中心因胰胆疾病接受EUS检查的316例连续患者。主要结果是间接征象的检出率及其在两种超声内镜类型之间的比较。该结果通过治疗权重逆概率（IPTW）分析得出。径向阵列内镜间接征象的检出率高于凸阵超声内镜（9.2%对2.3%（P=0.02））。单因素分析还显示，在IPTW后，径向阵列超声内镜在间接征象检测方面显著优于凸阵超声内镜（优势比，5.94；95%置信区间，1.68-21.10；P=0.01）。在调整磁共振成像（MRI）和计算机断层扫描（CT）后，径向阵列超声内镜仍是间接征象检测的独立因素（优势比，6.04；95%置信区间，1.74-21.00；P=0.01）。最后，5例有EUS间接征象的患者被诊断为胰腺癌。我们的结果表明，径向阵列超声内镜有助于检测间接征象。
