Accuracy of Endoscopic Ultrasound in Diagnosing and Staging Pancreatic Carcinoma
Accuracy of Endoscopic Ultrasound in Diagnosing and Staging Pancreatic Carcinoma
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超声内镜诊断和分期胰腺癌的准确性
DOI：
10.1159/000055872
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发表时间：
2001
期刊：
影响因子：
3.6
通讯作者：
M. Wiersema
中科院分区：
文献类型：
--
作者：
M. Wiersema
背景：腔内超声在胰腺癌诊断和分期中的作用正在演变。这篇综述的目的是介绍最近发表的材料，比较腔内超声相对于其他成像手段在评估疑似或已知胰腺癌患者时的表现。方法：用“腔内超声检查”和“胰腺肿瘤”两个词对Medline进行检索。对检索到的论文中的参考文献进行审查，以确定其他报告。重点放在过去3年内发表的同行评议材料，包括与其他成像方式的比较。结果：尽管横断面成像方法取得了进步，但腔内超声仍是识别胰腺肿块病变的最敏感和最特异的方法。确定胰腺癌可切除性的最佳方法是双期螺旋CT，尽管腔内超声检查可能会略微提高评估淋巴结的准确性。腔内超声引导细针抽吸活检术对怀疑胰腺癌但既往活检阴性的肿块患者具有较高的敏感性(93%)和特异性(100%)。结论：腔内超声检查可明确包含或排除肿块病变以及活检证实为恶性肿瘤，从而有助于胰腺肿瘤患者的诊断。腔内超声在确定可切除性方面的作用已被双期螺旋CT所取代。
Background: The role of endosonography in diagnosing and staging pancreatic adenocarcinoma is evolving. The aim of this review is to present recently published material comparing the performance of endosonography relative to other imaging modalities when evaluating a patient with a suspected or known carcinoma of the pancreas. Methods: Medline was searched using the terms ‘endosonography’ and ‘pancreas neoplasms’. References from retrieved papers were reviewed to identify other reports. Emphasis was placed on peer-reviewed material published within the past 3 years that included comparison with other imaging modalities. Results: Despite advances in cross-sectional imaging modalities, endosonography remains the most sensitive and specific method to identify pancreatic mass lesions. Resectability determination of pancreatic carcinoma is best done with dual-phase helical CT, although endosonography may have slightly improved accuracy for lymph node assessment. Endosonography-guided fine-needle aspiration biopsy has high sensitivity (93%) and specificity (100%) when employed in patients with masses in whom pancreatic cancer is suspected but prior biopsies are negative. Conclusions: Endosonography can aid in diagnosing patients with pancreatic neoplasms through definitive inclusion or exclusion of a mass lesion as well as biopsy confirmation of malignancy. The role of endosonography in determination of resectability has been eclipsed by dual-phase helical CT.