Lee Y T
Cancer. 1982 Mar 1;49(5):1035-9. doi: 10.1002/1097-0142(19820301)49:5<1035::aid-cncr2820490530>3.0.co;2-1.
In a county hospital, 217 patients were operated on for suspected cancer of the pancreas (186 patients) and periampullary structures (31 patients). The surgeons' philosophy was to avoid biopsy of the pancreas whenever possible, they often performed radical resection based on clinical judgment alone (8% of the resections were chronic pancreatitis). Follow-up of the 65 patients who were presumed to have carcinoma without histologic proof showed the surgeon's clinical diagnosis to be incorrect in over 7% of the cases (maximum error - 18%). Among patients with carcinoma of the pancreas, one third of the pancreatic biopsies missed the lesion (surgeon's sampling error). Frozen section examination of pancreatic biopsies in 63 patients showed false positive and negative rates of 3% and 4%, respectively (pathologist's sampling or interpretation errors). Two of 31 incisional biopsy of the pancreas resulted in pancreatic fistula; none of 24 needle biopsies did. Otherwise, biopsy of the pancreas did not influence mortality or morbidity after either resection or bypass procedures.
在一家县级医院，217例患者因疑似胰腺癌（186例）和壶腹周围结构癌（31例）接受了手术。外科医生的理念是尽可能避免对胰腺进行活检，他们常常仅根据临床判断就进行根治性切除（8%的切除病例为慢性胰腺炎）。对65例被推测患有癌症但无组织学证据的患者进行随访发现，外科医生的临床诊断在超过7%的病例中是错误的（最大误差为18%）。在胰腺癌患者中，三分之一的胰腺活检未发现病变（外科医生的取样误差）。对63例患者的胰腺活检进行冰冻切片检查显示，假阳性率和假阴性率分别为3%和4%（病理学家的取样或解读误差）。31例胰腺切开活检中有2例导致胰瘘；24例针吸活检均未导致胰瘘。否则，胰腺活检对切除或旁路手术后的死亡率或发病率没有影响。
