摘要
目的通过分析EUS-FNA获得的细胞量及细胞学诊断结果，比较3种不同型号穿刺针在胰腺实性占位诊断中的差异。方法纳入2010年12月至2011年5月期间两家医院胰腺实质性占位病灶长轴直径大于2cm并进行EUS-FNA的病例。根据穿刺途径将患者分为经胃壁穿刺组（19G或22G或25G）和经十二指肠壁穿刺组（22G或25G），分别按事先设置的随机表随机选择穿刺针型号进行EUS-FNA。穿刺过程中，固定穿刺次数、吸引负压、穿刺针在病灶内移动次数和移动距离，穿刺内容物送液基细胞学检查，由同一位细胞学医生制片及诊断对EUS-FNA获得的细胞量及细胞学诊断结果进行比较。结果研究共纳入病例52例，经胃壁穿刺组42例，经十二指肠壁穿刺组10例。所有病例均成功完成穿刺操作并未出现与EUS-FNA操作相关的并发症。两个穿刺组中不同型号穿刺针所获得的细胞总量、细胞学诊断之间的差异均无统计学意义（P〉0．05）。但在两组中25G穿刺针的诊断敏感度、特异度、阳性预测值、阴性预测值和准确率均稍高。结论EUS-FNA在胰腺实质性占位中具有较高的诊断价值，尽管25G穿刺针对胰腺病灶的诊断略显优势，但3种不同型号的穿刺针获得的细胞量及细胞学诊断并无显著差异。
Objective To compare the diagnostic yield of endoscopic uhrasound-guided fine needle aspiration （EUS-FNA） for solid pancreatic masses performed with three different needle types through the cytological results. Methods All patients with solid pancreatic masses larger than 2cm from December 2010 to May 2011 were enrolled, and divided into two groups according to different access of EUS-FNA, trans-gastile approach with 19-, 22- and 25-gauge needles （n = 42） and trans-duodenal approach with 22- and 25- gauge needles （ n = 10）. In both groups, EUS-FNA was performed with randomization of needle types. During the puncture, the suction, the number of movements, and the depth of insertion were fixed. At the end of the puncture, a liquid-based cytological （LBC） preparation was used to fix the specimen. One cytopathologists was assigned to make the diagnosis and comparison. Results Technical success was 100% and no procedure related complications occurred. No statistically significant differences were observed in different needles in terms of all cytological parameters between two groups （P 〉 0. 05 ）. However, the 25-gauge nee-dle showed a trend towards a higher sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Conclusion There is no significant difference in yield of cytological results between different needle types, although 25-gauge needle shows a relative superiority.
出处
《中华消化内镜杂志》
2012年第7期364-369,共6页
Chinese Journal of Digestive Endoscopy
基金
国家自然科学基金（30670941）
