Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions
Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology of Pancreatic Lesions
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DOI：
10.4132/jptm.2014.10.26
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发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Park, In Ae
中科院分区：
文献类型：
--
作者：
Baek, Hae Woon;Park, Min Jee;Park, In Ae
背景资料：超声内镜引导下细针穿刺细胞学检查（EUS-FNAC）是目前最常用的胰腺细胞学标本获取程序。它是准确的，微创的，安全的和成本效益。然而，细胞学诊断和手术诊断之间存在差异。本研究旨在评价EUS-FNAC对胰腺诊断的准确性。研究方法：我们对2010年至2012年期间在首尔国立大学医院病理科通过EUS-FNAC初步诊断并随后进行组织学诊断的191例胰腺病变进行了回顾性分析。细胞学和手术诊断分为五组：阴性，良性，非典型，恶性和诊断不足。随后，对167例手术和细胞学标本均符合要求的病例进行统计分析，以确定与诊断的相关性。结果如下：与手术诊断比较，细胞学诊断为真阳性103例（61.7%），真阴性28例（16.8%），假阳性9例（5.4%），假阴性27例（16.1%）。诊断准确率为78.4%，敏感性为79.2%，特异性为75.7%。阳性预测值为92.0%，阴性预测值为50.9%。结论：EUS-FNAC具有较高的准确性、敏感性、特异性和阳性预测价值。克服EUS-FNAC的局限性将使其成为一种有用和可靠的诊断工具，以准确评估胰腺病变。
Background: Endoscopic ultrasound-guided fine needle aspiration cytology (EUS-FNAC) is currently the most commonly used procedure for obtaining cytologic specimens of the pancreas. It is accurate, minimally invasive, safe and cost-effective. However, there is discrepancy between cytological and surgical diagnoses. This study was aimed at evaluating the diagnostic accuracy of EUS-FNAC of the pancreas. Methods: We performed a retrospective review of 191 cases of pancreatic lesions initially diagnosed by EUS-FNAC with subsequent histological diagnosis between 2010 and 2012 in the Department of Pathology, Seoul National University Hospital. Cytologic and surgical diagnoses were categorized into five groups: negative, benign, atypical, malignant, and insufficient for diagnosis. Subsequently, 167 cases with satisfactory yield in both surgical and cytology specimens were statistically analyzed to determine correlations with diagnosis. Results: In comparison to surgical diagnoses, cytologic diagnoses were true-positive in 103 cases (61.7%), true-negative in 28 cases (16.8%), false-positive in 9 cases (5.4%), and false-negative in 27 cases (16.1%). The diagnostic accuracy was 78.4%, sensitivity was 79.2%, and specificity was 75.7%. The positive predictive value was 92.0%, and negative predictive value was 50.9%. Conclusions: EUS-FNAC has high accuracy, sensitivity, specificity and positive predictive value. Overcoming the limitations of EUS-FNAC will make it a useful and reliable diagnostic tool for accurate evaluation of pancreatic lesions.