Karlson B M, Forsman C A, Wilander E, Skogseid B, Lindgren P G, Jacobson G, Rastad J
Department of Surgery, Uppsala University Hospital, Sweden.
Surgery. 1996 Jul;120(1):75-9. doi: 10.1016/s0039-6060(96)80244-3.
Radiologic diagnosis of pancreatic tumors exhibits limited precision. The aim of this study was to investigate the outcome and complications of pancreatic core biopsy in patients with suspected pancreatic neoplasms.
One hundred patients underwent ultrasonography-guided core biopsy of 1.2 mm external diameter. Medical charts were examined for biochemical and clinical signs of complications. Final diagnosis was settled by operation, autopsy, and clinical signs of the disease including survival with at least 2.3 years of follow-up.
Histopathologic biopsy evaluation showed correct discrimination between exocrine and endocrine tumors and nonneoplastic conditions in 89 patients. No false-positive cancer diagnosis was found, and guidance on nature of primary tumors was obtained for eight of eight metastases. The sensitivity was 91% for exocrine and 87% for endocrine pancreatic tumors, and negative predictive values of these diagnoses were 83% and 97%, respectively. No clinically significant complications were noted.
Core biopsy is an attractive alternative to diagnostic laparotomy in unresectable pancreatic cancer and efficiently provides diagnosis of endocrine tumors and pancreatic metastases in conjunction with rare complications. Benign biopsy findings cannot be used to exclude presence of primary or metastatic pancreatic neoplasms.
胰腺肿瘤的放射学诊断准确性有限。本研究旨在探讨疑似胰腺肿瘤患者胰腺穿刺活检的结果及并发症。
100例患者接受了外径1.2毫米的超声引导下穿刺活检。检查病历以了解并发症的生化和临床体征。最终诊断通过手术、尸检以及疾病的临床体征确定，随访时间至少为2.3年。
组织病理学活检评估显示，89例患者的外分泌性和内分泌性肿瘤以及非肿瘤性病变得到了正确区分。未发现假阳性癌症诊断，8例转移瘤中的8例获得了关于原发肿瘤性质的指导。外分泌性胰腺肿瘤的敏感性为91%，内分泌性胰腺肿瘤的敏感性为87%，这些诊断的阴性预测值分别为83%和97%。未观察到具有临床意义的并发症。
对于无法切除的胰腺癌，穿刺活检是诊断性剖腹手术的一种有吸引力的替代方法，能有效诊断内分泌肿瘤和胰腺转移瘤，且并发症罕见。良性活检结果不能用于排除原发性或转移性胰腺肿瘤的存在。
