Mie Takafumi, Sasaki Takashi, Takeda Tsuyoshi, Okamoto Takeshi, Mori Chinatsu, Furukawa Takaaki, Yamada Yuto, Kasuga Akiyoshi, Matsuyama Masato, Ozaka Masato, Sasahira Naoki
From the Department of Hepato-Biliary-Pancreatic Medicine, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan.
Pancreas. 2022 Sep 1;51(8):995-999. doi: 10.1097/MPA.0000000000002135.
Serial pancreatic-juice aspiration cytologic examination (SPACE) is useful for diagnosis of pancreatic ductal stenosis. This study investigates the utility of adding brush cytology to SPACE during the same procedure.
We retrospectively analyzed consecutive patients who underwent SPACE with brush cytology for pancreatic ductal stenosis between February 2014 and July 2020 in our hospital.
Thirty-four patients were included. Eleven had lesions in the pancreatic head lesions, and 23 had lesions in the pancreatic body or tail. Malignancies were found in 22 patients. Endoscopic ultrasound, computed tomography, and magnetic resonance imaging showed distal pancreatic duct dilation in 81.8% to 90.6% of cases, with a sensitivity of 63.0% to 65.5%. The sensitivity and diagnostic accuracy of SPACE, brush cytology, and SPACE with brush cytology were 63.6%, 50.0%, and 77.3% (P = 0.19) and 73.5%, 67.6%, and 82.4% (P = 0.42), respectively. No significant differences in diagnostic yield were observed for either pancreatic head lesions or pancreatic body/tail lesions. Post-endoscopic retrograde cholangiopancreatography pancreatitis was observed in 4 cases (11.8%).
The utility of adding brush cytology to SPACE was limited.
连续胰液抽吸细胞学检查（SPACE）对胰管狭窄的诊断很有用。本研究调查了在同一操作过程中，在SPACE基础上增加刷检细胞学的效用。
我们回顾性分析了2014年2月至2020年7月在我院因胰管狭窄接受SPACE联合刷检细胞学检查的连续患者。
共纳入34例患者。11例患者病变位于胰头，23例患者病变位于胰体或胰尾。22例患者发现恶性肿瘤。内镜超声、计算机断层扫描和磁共振成像显示81.8%至90.6%的病例存在胰管远端扩张，敏感性为63.0%至65.5%。SPACE、刷检细胞学以及SPACE联合刷检细胞学的敏感性和诊断准确性分别为63.6%、50.0%和77.3%（P = 0.19）以及73.5%、67.6%和82.4%（P = 0.42）。胰头病变或胰体/胰尾病变的诊断阳性率均未观察到显著差异。4例患者（11.8%）出现了内镜逆行胰胆管造影术后胰腺炎。
在SPACE基础上增加刷检细胞学的效用有限。
