Endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions provides inadequate material for cytology and laboratory analysis: initial results from a prospective study
Endoscopic ultrasound-guided fine-needle aspiration of pancreatic cystic lesions provides inadequate material for cytology and laboratory analysis: initial results from a prospective study
复制标题
DOI：
10.1055/s-0030-1256440
复制
发表时间：
2011-07-01
期刊：
影响因子：
9.3
通讯作者：
Fockens, P.
中科院分区：
文献类型：
--
作者：
de Jong, K.;Poley, J-W;Fockens, P.
背景与研究目的：超声内镜引导下细针穿刺（EUS-FNA）被认为是一种有价值且安全的胰腺囊性病变进一步检查技术。在EUS- fna准确性的前瞻性研究框架中，我们报告了关于穿刺通路、样本充分性和并发症的初步技术结果。患者和方法：连续接受EUS和EUS- fna的不确定胰腺囊性病变患者。收集胰腺囊肿液进行细胞病理学分析，测定淀粉酶、癌胚抗原（CEA）和碳水化合物抗原19.9 （CA 19.9）水平。该分析的主要结果参数是用于细胞学和实验室分析的样本的百分比。结果：143例接受EUS的患者（中位年龄63岁，中位囊肿大小2.8 cm）中，128例（90%）行FNA。不做FNA的原因包括换能器与囊性病变距离大（n = 9）、囊肿未见或太小（n = 2）、诊断明确不需要FNA （n = 3）。4例患者无法行FNA（技术故障）。送交细胞学检查的囊肿液仅在44例中提供了足够的细胞物质，占意向诊断率的31%（44/143）。68例（49%）获得足够的液体进行生化分析。3例（2.4%）出现并发症。结论：虽然eus引导下的FNA在大多数胰腺囊性病变患者（87%）技术上是可行的，但分别只有三分之一和一半的病例可能获得细胞病理学分类诊断和化学分析。
Background and study aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is considered a valuable and safe technique for further investigation of pancreatic cystic lesions. In the framework of a prospective study on the accuracy of EUS-FNA we report our initial technical results regarding puncture access, sample adequacy, and complicationsPatients and methods: Consecutive patients with indeterminate pancreatic cystic lesions underwent EUS and EUS-FNA. Pancreatic cyst fluid was collected for cytopathological analysis and measurement of amylase, carcinoembryonic antigen (CEA), and carbohydrate antigen 19.9 (CA 19.9) levels. Main outcome parameter for this analysis was the percentage of samples adequate for cytologic and laboratory analysis.Results: Of 143 patients (median age 63 years; median cyst size 2.8 cm) who underwent EUS, FNA was performed in 128 (90 %). The various reasons for not doing FNA included large distance between transducer and cystic lesion (n = 9), cyst not seen or too small (n = 2), and evident diagnosis not requiring FNA (n = 3). FNA was not possible in four patients (technical failures). Cyst fluid sent for cytology provided adequate cellular material in 44 cases only, accounting for an intention-to-diagnose yield of 31% (44/143). Sufficient fluid for biochemical analysis was obtained in 68 cases (49 %). Complications occurred in three patients (2.4 %).Conclusions: Although EUS-guided FNA was technically feasible in the majority of patients with pancreatic cystic lesions (87 %), it was possible to obtain a classifying cytopathologic diagnosis and a chemical analysis in only a third and a half of cases, respectively.