Endoscopic ultrasound-guided fine needle aspiration improves the pre-operative diagnostic yield of solid-pseudopapillary neoplasm of the pancreas: an international multicenter case series (with video)
Endoscopic ultrasound-guided fine needle aspiration improves the pre-operative diagnostic yield of solid-pseudopapillary neoplasm of the pancreas: an international multicenter case series (with video)
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DOI：
10.1007/s00464-014-3508-8
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发表时间：
2014-09-01
影响因子：
3.1
通讯作者：
Lennon, Anne Marie
中科院分区：
文献类型：
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作者：
Law, Joanna K.;Stoita, Alina;Lennon, Anne Marie
实性假乳头状肿瘤是一种罕见的胰腺肿瘤，多见于年轻女性，预后良好。计算机断层扫描（CT）最常用于识别这些病变，但很少有研究评估内镜超声（EUS）和细针穿刺（EUS- fna）在评估SPN中的作用。本研究的目的是确定EUS- fna在评估SPN患者时与CT或EUS相比的增量诊断率。回顾性分析1998年至2013年在3个国家5个中心连续接受CT、EUS和EUS- fna诊断为SPN的患者。回顾了患者的人口统计学、影像学、内窥镜检查、细胞病理学和组织学。34例患者被确诊为SPN。女性31例（91.2%），平均诊断年龄37岁（范围16-81岁）。最常见的症状是腹痛，59%的患者出现了腹痛。14例（41.2%）患者偶然检出spn。中位肿瘤大小为4.2 cm（范围1.9-9.4）。没有患者有局部或远处转移的证据。EUS上最常见的表现是混合性实囊性病变（67.6%）。单独CT和EUS的诊断率分别为23.5%和41.2%。CT和EUS的诊断率为52.9%。与CT或CT + EUS相比，EUS- fna的诊断率显著提高至82.4% （p < 0.005）。无不良事件报告。spn是一种罕见的胰腺肿瘤，主要影响年轻女性。EUS-FNA的加入使SPN的术前诊出率显著提高至82.4%。
Solid-pseudopapillary neoplasms (SPNs) are rare pancreatic tumors, which occur most frequently in young women and are associated with an excellent prognosis. Computed tomography (CT) is used most commonly to identify these lesions, but there are few studies evaluating the role of endoscopic ultrasound (EUS) and fine needle aspiration (EUS-FNA) in the assessment of SPN. The aim of the study was to determine the incremental diagnostic yield of EUS-FNA compared with CT or EUS in the evaluation of patients with SPN.A retrospective chart review of consecutive patients diagnosed with SPN who underwent CT, EUS, and EUS-FNA at five centers from three countries from 1998 to 2013. Patient demographics, imaging, endoscopic studies, cytopathology, and histology were reviewed.Thirty-four patients were identified with SPN. There were 31 (91.2 %) females, with a mean age at diagnosis of 37 years (range 16-81). The most common presenting symptom was abdominal pain which was present in 59 %. SPNs were incidentally detected in 14 (41.2 %) of the patients. The median tumor size was 4.2 cm (range 1.9-9.4). No patient had evidence of local or distant metastases. The most common appearance on EUS was of a mixed solid-cystic lesion (67.6 %). The diagnostic yield of CT and EUS alone was 23.5 and 41.2 %, respectively. CT and EUS combined had a diagnostic yield of 52.9 %. The addition of EUS-FNA significantly increased the diagnostic yield to 82.4 % compared with either CT or CT and EUS (p < 0.005). There were no reported adverse events reported.SPNs are rare pancreatic tumors primarily affecting young women. The addition of EUS-FNA significantly increased the pre-operative diagnostic yield of SPN to 82.4 %.