摘要
目的探讨内镜超声引导下细针穿刺活检(EUS-FNA)对胰腺占位性病变的诊断价值。方法从1998年10月至2006年9月,对190例胰腺占位病灶进行了超声内镜引导下穿刺活检,进行细胞学或病理学诊断。结果 (1)2006年1月以前未采用床旁染色观察时,EUS-FNA 诊断胰腺癌的敏感性为67.6%。2006年1月以后采用病理医师床旁瑞氏-姬姆萨快速染色观察法,EUS-FNA 诊断胰腺癌的敏感性提高到93.1%。(2)18例胰腺小占位病灶行 EUS-FNA,其诊断准确率是66.7%。(3)胰腺癌患者组中 EUS-FAN 活检物中的 CEA、CA19-9浓度明显高于血清中的浓度。(4)EUS-FNA对假肿瘤性胰腺炎诊断的准确率为76.5%。结论 EUS-FNA 对胰腺占位性病灶的诊断是安全有效的,具有重要价值。
Objective To evaluate significance of diagnosis and treatment guided by endoscopic ultrasonography（EUS） in pancreatic space-occupying lesion. Methods EUS-guided FNA （EUS-FNA） was performed in 190 patients （ 102 men and 88 women） with pancreatic space-occupying lesions detected by CT scanining, unhrasonography or clinically suspected diagnosis at Changhai hospital from October 1998 to April 2006. Eleven patients with pancreatic pseudocyst underwent EUS-guided stent insertion. Results （ 1 ） The diagnostic sensitivity of pancreatic adenocareinomas by EUS-FNA was 67.6% before January 2006, From then on, Wright-Giemsa fast-staining method was applied by pathologist at bedside and the diagnostic sensitivity was elevated to 93.1%. （2）18 cases of small pancreatic lesions were performed with EUS-FNA, the diagnostic accuracy of which was 42. 9%. （3） the diagnostic accuracy of Pseudotumorous pancreatitis was 76. 5%, （4） In EUS-FNA specimens of patients with pancreatic adenocarcinomas,the contents of CEA and CA19-9 were significantly higher than that in patients with chronic pancreatitis （ P 〈 0. 05 ）. Conclusion EUS-FNA was a effective and safe modality in diagnosis and treatment of pancreatic space-occupying lesion.
出处
《中华消化内镜杂志》
2007年第5期326-330,共5页
Chinese Journal of Digestive Endoscopy
基金
军队"十一五"面上项目(06MA165)
关键词
腔内超声检查
穿刺活检
胰腺占位性病变
Endosonography
Puncture biopsy
Pancreatic space-occupying lesion
