设为首页 | 加入收藏
| 欢迎光临本站!

消化内镜学分会官方网站

当前位置:文献追踪 > 国内外期刊

超声内镜引导下胰腺实性病变细针穿刺假阳性细胞学检查

发布日期:2014-1-29 12:40:19 文章来源:GIE 作者次数:1194

     

    背景
    目前普遍认为超声内镜引导下细针穿刺(EUS-FNA)细胞学分析胰腺病变的假阳性 (FP) 率小于1%。
    目的
    评估对接受过外科切割手术的假性胰腺癌患者行EUS-FNA(超声内镜引导下细针穿刺)的假阳性(FP)率。
    设计
    本研究为回顾性研究
    环境
    患者
    本研究有367例胰腺实性病变患者参加,他们的EUS-FNA(超声内镜引导下细针穿刺)细胞学检查结果被解释为阳性或疑似恶性肿瘤,故随后他们接受了外科手术切割。
    干预
    外科手术切除
    主要测量结果
    假阳性(FP)诊断的定义是:EUS – FNA(內镜超声引导下细针穿刺)细胞学检查标本被报告为“阳性”或“疑似恶性肿瘤”,但后来手术病理学证明其是良性。
    结果
    将367例患者中4例的“阳性”细胞学结果解释为恶性肿瘤,故EUS-FNA(內镜超声引导下细针穿刺)假阳性率为1.1%,而将367例患者中14例疑似和阳性这两种细胞学结果解释为恶性肿瘤,故其假阳性率为3.8%,在被错误解释为阳性的4例患者之间,有1例在细胞学上被错误诊断为神经内分泌肿瘤,3例被错误诊断为恶性腺瘤。依据外科病理学检查,所有的FP(假阳性)标本都是慢性胰腺炎。细胞学与外科病理学之间的这种检查结果不一致发生率不会随着时间而改变(2000-2006: 8/188 [4.3%] 对 2007-2010: 6/179 [3.4%];P =0.79)。
    局限性
    在一所单中心行回顾性研究。
    结论
    在一项回顾性队列试验中,EUS-FNA(內镜超声引导下细针穿刺)诊断实性胰腺病变的假阳性率是1.1%。目前的研究结果与之前用EUS-FNA(內镜超声引导下细针穿刺)诊断实性病变去评估细胞学FP(假阳性)率的研究相符合。FP(假阳性)案例的发生主要是由于细胞学对慢性胰腺炎的误诊。
    缩写词EUS-FNA为內镜超声引导下的细针穿刺术,FP假阳性。
     
     
    -------------------------------------------------------------------------------------------------------------------
    False-positive EUS-guided FNA cytology for solid pancreatic lesions
    Background
    The currently accepted paradigm is that the false-positive (FP) rate for EUS-guided fine-needle aspiration (EUS-FNA) cytologic analysis of a pancreatic lesion is less than 1%.
    Objective
    To assess the FP rate of EUS-FNA in patients who underwent surgical resection for presumed pancreatic cancer.
    Design
    Retrospective study.
    Setting
    Tertiary-care referral center.
    Patients
    This study involved 367 patients with solid pancreatic lesions in whom EUS-FNA cytology results were interpreted as positive or suspicious for malignancy, which resulted in subsequent surgical resection.
    Intervention
    Surgical resection.
    Main Outcome Measurements
    The FP diagnosis was defined as EUS-FNA cytology specimens being reported as “positive” or “suspicious for malignancy” but that were later proven to be benign on surgical pathology.
    Results
    The FP rate for EUS-FNA was 4 of 367 (1.1%) when only “positive” cytology findings were interpreted as malignant and 14 of 367 (3.8%) when both suspicious and positive cytology findings were interpreted as malignant. Among the 4 cases falsely interpreted as positive, 1 was falsely diagnosed cytologically as a neuroendocrine tumor and 3 as adenocarcinomas. All FP specimens showed chronic pancreatitis on surgical pathology. The incidence of discordance between cytology and surgical pathology did not change over time (2000-2006: 8/188 [4.3%] vs 2007-2010: 6/179 [3.4%]; P = .79).
    Limitations
    Retrospective study at a single center.
    Conclusion
    In a retrospective cohort trial, the FP rate for EUS-FNA of solid pancreatic lesions was 1.1%. Findings of the current study are in line with previous studies that have evaluated the FP cytology rates with EUS-FNA of solid lesions. FP cases transpired primarily as a result of cytologic misinterpretation in the setting of chronic pancreatitis.
     
     
     
     
     
    (作者:)
相关评论
用户名: 登录