Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration in patients with presumed pancreatic cancer
Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration in patients with presumed pancreatic cancer
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DOI：
10.1016/s1091-255x(02)00150-6
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发表时间：
2003-01-01
影响因子：
3.2
通讯作者：
Evans, DB
中科院分区：
文献类型：
--
作者：
Raut, CP;Grau, AJ;Evans, DB
内镜超声（EUS）引导下胰腺细针穿刺（FNA）可以在不进行探查手术的情况下诊断胰腺癌。我们回顾了我们最近的经验，EUS-FNA的病人假定胰腺癌和报告的诊断准确性和并发症的这种程序。我们回顾了1999年11月1日至2001年10月1日期间在我们机构接受EUS-FNA的所有CT显示胰腺肿块或恶性胆管狭窄的患者的数据。根据对比增强、多层螺旋CT扫描的结果，将患者分为可切除、局部晚期或转移性疾病。对233例患者进行了EUS-FNA。216名患者（93%）最终诊断为癌症，15名患者（6%）被发现患有良性疾病，2名患者（1%）的最终诊断仍然未知。EUS-FNA诊断胰腺恶性肿瘤的敏感性、特异性和准确性分别为91%、100%和92%。对于随后证实患有癌症的216名患者，EUS-FNA的结果在197名（91%）中得到诊断; 107名可切除疾病患者中有96名（90%），64名局部晚期疾病患者中有62名（97%），45名转移性疾病患者中有39名（87%）。4例患者（2%）发生了需要住院的临床明显并发症，包括2例需要手术治疗十二指肠穿孔的患者。无EUS相关死亡。我们的结论是，EUS-FNA可以安全，准确地建立细胞学诊断的早期和晚期胰腺癌患者。这使得能够考虑所有治疗选择，包括基于方案的治疗。
Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of the pancreas allows the diagnosis of pancreatic cancer to be established without exploratory surgery. We reviewed our recent experience with EUS-FNA in patients with presumed pancreatic cancer and report the diagnostic accuracy and complications of this procedure. Data were reviewed from all patients who presented with CT evidence of a pancreatic mass or a malignant biliary stricture and underwent EUS-FNA at our institution between November 1, 1999, and October 1, 2001. Based on the findings of contrast-enhanced, multislice CT scanning, patients were categorized as having resectable, locally advanced, or metastatic disease. EUS-FNA was performed in 23 3 patients. A final diagnosis of cancer was established in 216 patients (93%), 15 patients (6%) were found to have benign disease, and the final diagnosis remains unknown in two patients (1%). The sensitivity, specificity, and accuracy of EUS-FNA for diagnosis of a pancreatic malignancy were 91%, 100%, and 92%, respectively. For the 216 patients subsequently proven to have cancer, the results of EUS-FNA were diagnostic in 197 (91%); 96 (90%) of 107 patients with resectable disease, 62 (97%) of 64 with locally advanced disease, and 39 (87%) of 45 with metastatic disease. Four patients (2%) developed a clinically apparent complication that required hospital admission, including two patients who required surgery for duodenal perforation. There were no EUS-related deaths. We conclude that EUS-FNA can safely and accurately establish a cytologic diagnosis in patients with both early-stage and advanced pancreatic cancer. This enables consideration of all treatment options including protocol-based therapy.