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超声内镜在胰腺占位性疾病诊断中的价值
Value of endoscopic ultrasonography in diagnosis of pancreatic space-occupying diseases
文章发布日期:2018年07月06日  来源:  作者:吴斌,沈亦钰,陈徐艰,等  点击次数:385次  下载次数:39次

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【摘要】:目的探讨超声内镜(EUS)检查在胰腺占位性疾病中的应用价值。方法纳入2015年1月-2017年1月嘉兴学院附属第二医院诊治的可疑胰腺占位性疾病患者85例,以手术病理或随访结果作为金标准,评价EUS及EUS引导下穿刺活组织检查(EUS-FNA)在胰腺占位的应用价值。计数资料组间比较采用配对样本χ2检验。结果EUS对胰腺占位的影像学检出率为967%(59/61),特异度为100%(24/24),准确率为97.6%(83/85);EUS在检出率和准确率上均明显优于腹部B超、CT和MRI(检出率:χ2=4.344、3.873、15.445;准确率:χ2=6.675、8.685、17.389,P值均<0.05)。EUS-FNA对肿瘤性占位的检出率和准确率分别为81.8%(45/55)、81.0% (47/58)。在手术明确病理的患者中,术前EUS-FNA检查的总体符合率为84.2% (16/19)。结论EUS较常规影像学检查对于胰腺占位具有更高的影像学准确率,EUS-FNA可进一步明确占位性质、病理类型,EUS可为胰腺肿瘤的早期诊断、治疗提供帮助。
【Abstract】:ObjectiveTo investigate the value of endoscopic ultrasonography (EUS) in the diagnosis of pancreatic space-occupying diseases. MethodsA total of 85 patients with suspected pancreatic space-occupying diseases who were treated in The Second Affiliated Hospital of Jiaxing College from January 2015 to January 2017 were enrolled. Surgical pathological results or follow-up results were used as the gold standard for evaluating the value of EUS and EUS-guided fine needle aspiration (EUS-FNA) in the diagnosis of pancreatic space-occupying diseases. The chi-square test was used for comparison of categorical data between groups. ResultsEUS had an imaging detection rate of 96.7% (59/61), a specificity of 100% (24/24), and an accuracy rate of 97.6% (83/85) in the diagnosis of pancreatic space-occupying diseases; EUS had significantly higher detection rate and accuracy rate than abdominal ultrasound, computed tomography, and magnetic resonance imaging (detection rate: χ2=4.344, 3.873, and 15.445, all P<0.05; accuracy rate: χ2=6.675, 8.685, and 17389, all P<0.05). EUS-FNA had a detection rate of 81.8% (45/55) and an accuracy rate of 81.0% (47/58). Among the patients who underwent surgery to have pathological results, the overall coincidence rate of preoperative EUS-FNA was 84.2% (16/19). ConclusionCompared with conventional imaging examinations, EUS has a higher diagnostic accuracy for pancreatic space-occupying diseases, and EUS-FNA can further clarify the nature and pathological type of space-occupying lesions. EUS may help with the early diagnosis and treatment of pancreatic tumors.
【关键字】:超声内镜; 胰腺肿瘤; 活组织检查, 针吸; 诊断
【Key words】:endoscopic ultrasonography; pancreatic neoplasms; biopsy, needle; dignosis
【引证本文】:WU B, SHEN YY, CHEN XJ, et al. Value of endoscopic ultrasonography in diagnosis of pancreatic space-occupying diseases[J]. J Clin Hepatol, 2018, 34(8): 1723-1727. (in Chinese)
吴斌, 沈亦钰, 陈徐艰, 等. 超声内镜在胰腺占位性疾病诊断中的价值[J]. 临床肝胆病杂志, 2018, 34(8): 1723-1727.

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