Role of endoscopic ultrasound in the diagnosis of pancreatic cancer
Role of endoscopic ultrasound in the diagnosis of pancreatic cancer
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DOI：
10.4251/wjgo.v6.i9.360
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发表时间：
2014-09-15
影响因子：
3
通讯作者：
Perez-Miranda, Manuel
中科院分区：
文献类型：
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作者：
Gonzalo-Marin, Juana;Jose Vila, Juan;Perez-Miranda, Manuel
内镜超声检查（EUS）与或没有细针抽吸已成为主要技术评价胰胆管疾病，并已被证明有较高的诊断率比正电子发射断层扫描，计算机断层扫描（CT）和经腹超声识别早期胰腺肿瘤。作为胰腺癌的诊断方法，EUS的诊断率高于90%，特别是对于小于2-3 cm的病变，其敏感性达到99%，而CT为55%。此外，EUS具有非常高的阴性预测值，因此EUS可以可靠地排除胰腺癌。EUS的并发症发生率低至1.1%~ 3.0%。弹性成像和造影剂的使用等新的技术发展最近已应用于EUS，提高了其诊断能力。研究发现，EUS在T分期方面上级于最近的多排CT，与CT和磁共振成像相比，逾期风险更低，因此患者不会被排除在潜在的有益切除之外。EUS对N分期的准确率为64%~ 82%。在不可切除的癌症中，EUS还通过腹腔神经丛阻滞治疗肿瘤疼痛，在无法负担内窥镜逆行胰胆管造影术的患者中进行梗阻性黄疸的胆道引流以及辅助放疗和化疗来发挥治疗作用。(C)2014百世登出版集团股份有限公司All rights reserved.
Endoscopic ultrasonography (EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography, computed tomography (CT) and transabdominal ultrasound for recognising early pancreatic tumors. As a diagnostic modality for pancreatic cancer, EUS has proved rates higher than 90%, especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for CT. Besides, EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic cancer. The complication rate of EUS is as low as 1.1%-3.0%. New technical developments such as elastography and the use of contrast agents have recently been applied to EUS, improving its diagnostic capability. EUS has been found to be superior to the recent multidetector CT for T staging with less risk of overstaying in comparison to both CT and magnetic resonance imaging, so that patients are not being ruled out of a potentially beneficial resection. The accuracy for N staging with EUS is 64%-82%. In unresectable cancers, EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block, biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.