Zhang Ping-Ping, Wang Teng, Li Shi-Yu, Li Li, Su Xiao-Ju, Gu Pei-Yuan, Qian Yi-Ping, Li Feng, Gao Li, Jin Zhen-Dong, Wang Kai-Xuan
Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Department of Spleen and Stomach and Rheumatology, Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University, Luzhou, Sichuan Province, China.
Endosc Ultrasound. 2022 May-Jun;11(3):208-215. doi: 10.4103/EUS-D-21-00119.
An atypical cytologic diagnosis arises from inflammation or early neoplastic process. It is commonly found in EUS-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) tissue sampling of pancreatic malignancies. The aims of this study were to evaluate the diagnostic performance of EUS-FNA/FNB in patients with cytologic diagnosis of atypical cells and to develop a prediction model for malignant tumors of the pancreas in the atypical cytologic diagnostic category.
Two hundred and twenty-six patients in the atypical cytologic diagnostic category were analyzed. Multivariate logistic regression analyses were performed to determine predictive factors for pancreatic malignancies. The final diagnoses were confirmed by repeat biopsy; surgical pathology, or clinical follow-up for at least 6 months.
The atypical cytologic diagnosis using EUS-FNA/FNB was associated with an absolute risk of malignancy (82.3%). Multivariate logistic regression analyses revealed that older age, long axis of the mass, and increased carbohydrate antigen 19-9 (CA19-9) were independent risk factors for true malignant pancreatic tumors among patients in the atypical cytologic diagnostic category. The calibration curve had a slope of 0.96, and a regression coefficient (R) of 0.91. The area under the receiver operating characteristic curve of the validation group was 0.803.
Atypical lesions of EUS-FNA/FNB have a higher risk of malignancy. Older age, the long axis of the mass, and elevated serum CA19-9 level were identified as independent risk factors for true malignant pancreatic tumors among patients in the atypical cytologic diagnostic category.
非典型细胞学诊断源于炎症或早期肿瘤形成过程。它常见于胰腺恶性肿瘤的超声内镜引导下细针穿刺抽吸/活检（EUS-FNA/FNB）组织采样中。本研究的目的是评估EUS-FNA/FNB在非典型细胞细胞学诊断患者中的诊断性能，并建立非典型细胞学诊断类别中胰腺恶性肿瘤的预测模型。
分析了226例非典型细胞学诊断类别的患者。进行多因素逻辑回归分析以确定胰腺恶性肿瘤的预测因素。最终诊断通过重复活检、手术病理或至少6个月的临床随访得以证实。
使用EUS-FNA/FNB进行的非典型细胞学诊断与恶性肿瘤的绝对风险相关（82.3%）。多因素逻辑回归分析显示，年龄较大、肿块长轴以及糖类抗原19-9（CA19-9）升高是非典型细胞学诊断类别患者中真正胰腺恶性肿瘤的独立危险因素。校准曲线的斜率为0.96，回归系数（R）为0.91。验证组的受试者工作特征曲线下面积为0.803。
EUS-FNA/FNB的非典型病变具有较高的恶性风险。年龄较大、肿块长轴以及血清CA19-9水平升高被确定为非典型细胞学诊断类别患者中真正胰腺恶性肿瘤的独立危险因素。
