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内镜超声引导下细针穿刺抽吸术细胞块和液基细胞学检查对胰腺肿瘤的诊断效能。

Diagnostic Efficacy of Cell Block and Liquid-Based Cytology for Endoscopic Ultrasound-Guided Fine Needle Aspiration in Pancreatic Tumors.

机构信息

Department of Gastroenterology, University of Health Sciences İzmir Bozyaka Training and Education Hospital, İzmir, Türkiye.

Department of Gastroenterology, Bakırçay University Çiğli Training and Education Hospital, İzmir, Türkiye.

出版信息

Turk J Gastroenterol. 2024 Jul 3;35(8):665-674. doi: 10.5152/tjg.2024.23609.

Abstract

This study aimed to evaluate the diagnostic efficacy of cell block (CB) and liquid-based cytology (LBC) for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic tumors. The study included patients who underwent EUS-FNA for pancreatic tumors between January 2015 and February 2021 and whose cytology samples were both processed for LBC and CB. Data of 390 patients (220 men, mean age: 64.2 ± 11.4 years) were retrospectively analyzed. Of the detected lesions (size: 17-120 mm; mean: 39.9 ± 13.9 mm), 220 (56.4%) were located in the head and uncinate process of the pancreas. Lesions in 339 (86.9%) patients were diagnosed as malignant using CB and/or LBC and suspicious for malignancy in 44 (11.3%) patients. In 7 patients with non-diagnostic (6 cases) or negative for malignancy (1 case) EUS-FNA results using both methods, the diagnosis of malignancy was established via ultrasound-guided percutaneous biopsy. Malignancy was detected in 324 (92.4%), 313 (87.9%), and 298 (87.9%) patients using CB, LBC, and both CB and LBC, respectively. Final diagnosis was obtained in 339 (98%) patients by using CB and/or LBC. The combined use of the both methods exhibited significantly superior diagnostic accuracy compared with CB and LBC alone (P < .001). Liquid-based cytology and CB exhibit high diagnostic accuracy for the detection of pancreatic tumors in patients undergoing EUS-FNA. The combined use of both methods showed a significantly higher diagnostic accuracy than LBC and CB alone.

摘要

本研究旨在评估细胞块(CB)和液基细胞学(LBC)在超声内镜引导下细针抽吸(EUS-FNA)诊断胰腺肿瘤中的诊断效能。研究纳入了 2015 年 1 月至 2021 年 2 月期间因胰腺肿瘤接受 EUS-FNA 检查且细胞学样本同时进行 LBC 和 CB 处理的患者。回顾性分析了 390 例患者(220 例男性,平均年龄:64.2±11.4 岁)的数据。检测到的病变(大小:17-120mm;平均:39.9±13.9mm)中,220 例(56.4%)位于胰头和钩突。339 例(86.9%)患者的 CB 和/或 LBC 诊断为恶性,44 例(11.3%)患者可疑恶性。在 7 例两种方法均未诊断(6 例)或未诊断为恶性(1 例)的 EUS-FNA 结果中,通过超声引导经皮活检确定为恶性。使用 CB、LBC 和 CB 和 LBC 联合检测,分别在 324 例(92.4%)、313 例(87.9%)和 298 例(87.9%)患者中检测到恶性肿瘤。339 例(98%)患者通过使用 CB 和/或 LBC 获得最终诊断。与单独使用 CB 和 LBC 相比,两种方法联合使用的诊断准确性显著更高(P<0.001)。液基细胞学和 CB 对 EUS-FNA 检查的胰腺肿瘤患者具有较高的诊断准确性。两种方法联合使用的诊断准确性显著高于单独使用 LBC 和 CB。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e54d/11363155/7ef08a2e47fa/tjg-35-8-665_f001.jpg

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