对比增强谐波内镜超声是否应纳入国际共识指南以确定导管内乳头状黏液性肿瘤的适当治疗？

Should Contrast-Enhanced Harmonic Endoscopic Ultrasound Be Incorporated into the International Consensus Guidelines to Determine the Appropriate Treatment of Intraductal Papillary Mucinous Neoplasm?

作者信息

Yamazaki Tomohiro, Takenaka Mamoru, Omoto Shunsuke, Yoshikawa Tomoe, Ishikawa Rei, Okamoto Ayana, Nakai Atsushi, Minaga Kosuke, Kamata Ken, Yamao Kentaro, Komeda Yoriaki, Watanabe Tomohiro, Nishida Naoshi, Kamei Keiko, Matsumoto Ippei, Takeyama Yoshifumi, Chikugo Takaaki, Chiba Yasutaka, Kudo Masatoshi

机构信息

Department of Gastroenterology and Hepatology, Faculty of Medicine, Kindai University, Osaka-Sayama 589-8511, Japan.

Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Faculty of Medicine, Kindai University, Osaka-Sayama 589-8511, Japan.

出版信息

J Clin Med. 2021 Apr 22;10(9):1818. doi: 10.3390/jcm10091818.

DOI:10.3390/jcm10091818

PMID:33921949

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8122438/

Abstract

This study aimed to investigate whether the incorporation of contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) into the international consensus guidelines (ICG) for the management of intraductal papillary mucinous neoplasm (IPMN) could improve its malignancy diagnostic value. In this single-center retrospective study, 109 patients diagnosed with IPMN who underwent preoperative CH-EUS between March 2010 and December 2018 were enrolled. We analyzed each malignancy diagnostic value (sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV)) by replacing fundamental B-mode EUS with CH-EUS as the recommended test for patients with worrisome features (WF) (the CH-EUS incorporation ICG) and comparing the results to those obtained using the 2017 ICG. The malignancy diagnostic values as per the 2017 ICG were 78.9%, 42.3%, 60.0%, and 64.7% for Se, Sp, PPV, and NPV, respectively. The CH-EUS incorporation ICG plan improved the malignancy diagnostic values (Se 78.9%/Sp, 53.8%/PPV, 65.2%/NPV 70.0%). CH-EUS may be useful in determining the appropriate treatment strategies for IPMN.

摘要

本研究旨在探讨将对比增强谐波内镜超声（CH-EUS）纳入国际导管内乳头状黏液性肿瘤（IPMN）管理共识指南（ICG）是否能提高其恶性诊断价值。在这项单中心回顾性研究中，纳入了2010年3月至2018年12月期间接受术前CH-EUS检查且诊断为IPMN的109例患者。我们通过将基础B型超声内镜（EUS）替换为CH-EUS作为对具有可疑特征（WF）患者的推荐检查（CH-EUS纳入ICG），分析了各项恶性诊断价值（敏感性（Se）、特异性（Sp）、阳性预测值（PPV）和阴性预测值（NPV）），并将结果与使用2017年ICG获得的结果进行比较。根据2017年ICG，Se、Sp、PPV和NPV的恶性诊断价值分别为78.9%、42.3%、60.0%和64.7%。CH-EUS纳入ICG方案提高了恶性诊断价值（Se 78.9%/Sp 53.8%/PPV 65.2%/NPV 70.0%）。CH-EUS可能有助于确定IPMN的适当治疗策略。