中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2014年
5期
307-310
,共4页
王仕迎%冯兰云%王鹏%陈顥%林钧华%朱晓燕%沈晔华%陈震%孟志强
王仕迎%馮蘭雲%王鵬%陳顥%林鈞華%硃曉燕%瀋曄華%陳震%孟誌彊
왕사영%풍란운%왕붕%진호%림균화%주효연%침엽화%진진%맹지강
超声检查%活组织检查,细针%胰腺肿瘤
超聲檢查%活組織檢查,細針%胰腺腫瘤
초성검사%활조직검사,세침%이선종류
Ultrasonography%Biopsy,fine-needle%Pancreatic neoplasm
目的 评价超声引导经皮细针穿刺(US-FNA)胰腺肿块细胞病理学检查对胰腺肿块诊断的准确度及安全性.方法 对2008年1月至2013年2月250例经US-FNA取得细胞病理学诊断的胰腺肿块患者进行回顾性分析.计算US-FNA对胰腺肿块诊断的敏感度、特异度、阳性预测值、阴性预测值和准确度.准确度的分层比较采用Pearson卡方检验.结果 250例患者胰腺肿块US-FNA细胞学结果中,221例见癌细胞,2例见异型细胞和9例疑癌最终均证实为恶性;18例细胞学诊断为良性患者(增生的腺上皮细胞2例,见组织液化坏死2例,见炎性细胞1例,未见恶性肿瘤细胞13例)中,最终证实为恶性12例,良性6例(胰腺良性肿瘤3例,胰腺假性囊肿1例,胰腺结核1例,胰腺炎1例).US-FNA的病理诊断敏感度、特异度、阳性预测值、阴性预测值和准确度分别为90.57％、100.00％、100.00％、20.68％和90.80％.分层分析发现,US-FNA对最大径≥3 cm胰腺肿块诊断准确性高于＜3 cm者,但差异无统计学意义(P＞0.05).250例患者中,45例出现穿刺后腹部轻度钝痛,均自愈,未发现其他并发症.随访至患者死亡或≥6个月未见腹腔针道种植播散.结论 US-FNA对胰腺肿块诊断准确率高(尤其是对最大径≥3 cm的肿瘤)、安全性良好、费用低、操作简便,是获取不可切除的胰腺占位病变病理诊断的良好选择.
目的 評價超聲引導經皮細針穿刺(US-FNA)胰腺腫塊細胞病理學檢查對胰腺腫塊診斷的準確度及安全性.方法 對2008年1月至2013年2月250例經US-FNA取得細胞病理學診斷的胰腺腫塊患者進行迴顧性分析.計算US-FNA對胰腺腫塊診斷的敏感度、特異度、暘性預測值、陰性預測值和準確度.準確度的分層比較採用Pearson卡方檢驗.結果 250例患者胰腺腫塊US-FNA細胞學結果中,221例見癌細胞,2例見異型細胞和9例疑癌最終均證實為噁性;18例細胞學診斷為良性患者(增生的腺上皮細胞2例,見組織液化壞死2例,見炎性細胞1例,未見噁性腫瘤細胞13例)中,最終證實為噁性12例,良性6例(胰腺良性腫瘤3例,胰腺假性囊腫1例,胰腺結覈1例,胰腺炎1例).US-FNA的病理診斷敏感度、特異度、暘性預測值、陰性預測值和準確度分彆為90.57％、100.00％、100.00％、20.68％和90.80％.分層分析髮現,US-FNA對最大徑≥3 cm胰腺腫塊診斷準確性高于＜3 cm者,但差異無統計學意義(P＞0.05).250例患者中,45例齣現穿刺後腹部輕度鈍痛,均自愈,未髮現其他併髮癥.隨訪至患者死亡或≥6箇月未見腹腔針道種植播散.結論 US-FNA對胰腺腫塊診斷準確率高(尤其是對最大徑≥3 cm的腫瘤)、安全性良好、費用低、操作簡便,是穫取不可切除的胰腺佔位病變病理診斷的良好選擇.
목적 평개초성인도경피세침천자(US-FNA)이선종괴세포병이학검사대이선종괴진단적준학도급안전성.방법 대2008년1월지2013년2월250례경US-FNA취득세포병이학진단적이선종괴환자진행회고성분석.계산US-FNA대이선종괴진단적민감도、특이도、양성예측치、음성예측치화준학도.준학도적분층비교채용Pearson잡방검험.결과 250례환자이선종괴US-FNA세포학결과중,221례견암세포,2례견이형세포화9례의암최종균증실위악성;18례세포학진단위량성환자(증생적선상피세포2례,견조직액화배사2례,견염성세포1례,미견악성종류세포13례)중,최종증실위악성12례,량성6례(이선량성종류3례,이선가성낭종1례,이선결핵1례,이선염1례).US-FNA적병리진단민감도、특이도、양성예측치、음성예측치화준학도분별위90.57％、100.00％、100.00％、20.68％화90.80％.분층분석발현,US-FNA대최대경≥3 cm이선종괴진단준학성고우＜3 cm자,단차이무통계학의의(P＞0.05).250례환자중,45례출현천자후복부경도둔통,균자유,미발현기타병발증.수방지환자사망혹≥6개월미견복강침도충식파산.결론 US-FNA대이선종괴진단준학솔고(우기시대최대경≥3 cm적종류)、안전성량호、비용저、조작간편,시획취불가절제적이선점위병변병리진단적량호선택.
Objective To assess the accuracy and safety of cytopathological diagnosis of ultrasound guided fine needle aspirated(US-FNA)pancreatic masses.Methods From January 2008 to February 2013,250 pancreatic mass cases underwent US-FNA and with cytopathological diagnosis were retrospectively analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were calculated.The stratified analysis of accuracy was compared by Pearson x2 test.Results Among 250 patients,the results of US-FNA cytological analysis indicated that cancer cells were found in 221 cases; atypical cells in two cases; nine cases were suspicious cancer and all of them were confirmed malignant in the end.Among the 18 patients with negative diagnostic results (epithelial cell proliferated in two cases,tissue liquefaction necrosis in two cases,inflammatory cells in one case and 13 cases without malignant cells) 12 cases were finally proved malignant and six cases were benign (three cases of pancreatic benign tumor,one case of pancreatic pseudocyst,one case of pancreatic tuberculosis and one case of pancreatitis).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of US-FNA in pathological diagnosis were 90.57％,100.00％,100.00％,20.68％ and 90.80％,respectively.The results of stratified analysis indicated that the diagnostic accuracy of US-FNA in mass with diameter ≥3 cm was significantly higher than that with diameter ＜3 cm,but the difference wasn't statistically significant (P＞0.05).Among 250 patients,45 patients had slight abdominal pain and all were self healing.No other complications were found.All patients were followed up until death or at least six months and no peritoneal spread through needle tract seeding was detected after long time follow-up.Conclusions The US-FNA in pancreatic mass diagnosis has a high accuracy and a good safety with low cost and easy operation.It is a good choice for the pathological diagnosis of unresectable pancreatic lesion.
