超声内镜在胰腺占位性疾病诊断中的价值

吴斌; 沈亦钰; 陈徐艰; 钟海; 王晓光; 宋政炜; 钟征翔

doi:10.3969/j.issn.1001-5256.2018.08.026

超声内镜在胰腺占位性疾病诊断中的价值

DOI: 10.3969/j.issn.1001-5256.2018.08.026

嘉兴学院附属第二医院肝胆胰外科

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中图分类号: R735.9
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出版历程
- 收稿日期: 2018-01-11
- 出版日期: 2018-08-20

Value of endoscopic ultrasonography in diagnosis of pancreatic space-occupying diseases

Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Jiaxing College

摘要

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...
- 超声内镜 /
- 胰腺肿瘤 /
- 活组织检查,针吸 /
- 诊断
Abstract: Objective To investigate the value of endoscopic ultrasonography ( EUS) in the diagnosis of pancreatic space-occupying diseases. Methods A 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. Results EUS 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) . Conclusion Compared 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.
- endoscopic ultrasonography /
- pancreatic neoplasms /
- biopsy, needle /
- dignosis

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参考文献(13)

[1]QU GB, SONG MM.Early diagnosis and treatment of pancreatic cancer[J].Int J Surg, 2017, 44 (6) :364-367. (in Chinese) 曲更宝, 宋茂民.胰腺癌的早期诊断和治疗进展[J].国际外科学杂志, 2017, 44 (6) :364-367.

[2]ZHANG ST, WANG YJ.How to make better use of gastrointestinal endoscopy in diagnosis and treatment of biliary and pancreatic diseases[J].J Clin Hepatol, 2017, 33 (4) :607-610. (in Chinese) 张澍田, 王拥军.如何更好地利用消化内镜诊治胆胰疾病[J].临床肝胆病杂志, 2017, 33 (4) :607-610.

[3]LIU YM.The role of endoscopic ultrasound in detection of small pancreatic tumors[J].China Oncol, 2017, 27 (3) :233-236. (in Chinese) 刘玉美.超声内镜对胰腺小肿瘤的诊断价值[J].中国癌症杂志, 2017, 27 (3) :233-236.

[4]HOU XJ, JIN ZD.Diagnostic value of endoscopic ultrasonography for pancreatic head mass[J].J Clin Hepatol, 2014, 30 (12) :1255-1258. (in Chinese) 侯晓佳, 金震东.超声内镜检查在胰头占位性病灶中的诊断价值[J].临床肝胆病杂志, 2014, 30 (12) :1255-1258.

[5]MAGUCHI H.The roles of endoscopic ultrasonography in the diagnosis of pancreatic tumors[J].J Hepatobiliary Pancreat Surg, 2004, 11 (1) :1-3.

[6]KITANO M, KUDO M, YAMAO K, et al.Characterization of small solid tumors in the pancreas:The value of contrast-enhanced harmonic endoscopic ultrasonography[J].Am J Gastroenterol, 2012, 107 (2) :303-310.

[7]HANADA K, OKAZAKI A, HIRANO N, et al.Effective screening for early diagnosis of pancreatic cancer[J].Best Pract Res Clin Gastroenterol, 2015, 29 (6) :929-939.

[8]SUN R, GAO XL, MA YX.Application of bile duct and pancreatic duct dilatation in the diagnosis of pancreatic cancer by ultrasound[J].Chin J Mod Drug Appl, 2016, 10 (13) :60-61. (in Chinese) 孙瑞, 高晓丽, 马悦霞.胆管、胰管扩张在超声诊断胰腺癌中的应用价值分析[J].中国现代药物应用, 2016, 10 (13) :60-61.

[9]HE Q, XU YQ.Application of endoscopic ultrasonography in diagnosis of pancreatic cancer and related research advances[J].J Clin Hepatol, 2016, 32 (7) :1280-1282. (in Chinese) 何强, 徐有青.超声内镜在胰腺癌诊断中的应用及进展[J].临床肝胆病杂志, 2016, 32 (7) :1280-1282.

[10]JIANG HM.Clinical significance of endoscopic ultrasonography in TNM staging of gastric cancer[J].Med J Ind Enterpr, 2014, 27 (1) :586-587. (in Chinese) 蒋汉梅.超声内镜对胃癌TNM分期的临床意义[J].工企医刊, 2014, 27 (1) :586-587.

[11]SUN L.Diagnostic value of color Doppler ultrasound for mass type pancreatitis and pancreatic cancer[J].Hebei Med J, 2016, 38 (12) :1816-1818. (in Chinese) 孙雷.彩色多普勒超声对肿块型胰腺炎和胰腺癌的诊断价值[J].河北医药, 2016, 38 (12) :1816-1818.

[12]QIN SY, JIANG HX, LI P, et al.The diagnostic value of endoscopic ultrasound-guided fine-needle aspiration biopsy of cell block with immunostaining for pancreatic lesions[J].Chin J Dig Endosc, 2014, 31 (6) :312-316. (in Chinese) 覃山羽, 姜海行, 李萍, 等.细胞块结合免疫组化在内镜超声引导下穿刺诊断胰腺实性占位中的应用价值[J].中华消化内镜杂志, 2014, 31 (6) :312-316.

[13]HUANG Q, LIU CH, PENG B, et al.The diagnostic value and safety of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in pancreatic lesions[J].J Hepatobiliary Surg, 2016, 24 (3) :175-178. (in Chinese) 黄强, 刘臣海, 彭斌, 等.超声内镜引导下细针穿刺活检 (EUS-FNA) 在胰腺占位性病变中的诊断价值及安全性评估[J].肝胆外科杂志, 2016, 24 (3) :175-178.

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