微创医学

目的探讨胰腺囊性病变行超声内镜下细针穿刺活检术的诊断体会。方法分析我院30例胰腺囊性病变行传统影像学检查（CT、MRI、B超）、EUSFNA的临床资料，其中16例行液基细胞学（LBC）、细胞块检查。通过比较各种检查结果的诊断正确率、灵敏度、特异度、Youden指数，确定EUSFNA对于胰腺囊性病变的诊断价值，并以此总结胰腺囊性病变行超声内镜下细针穿刺的操作技巧。结果胰腺癌6例，囊腺癌4例，假性囊肿14例，黏液性囊腺瘤4例，胰腺导管内乳头状黏液瘤（IPMN）2例。传统影像学、EUSFNA、LBC、细胞块的诊断正确率为56.67%、90%、73.33%、100%（P＜0.05）。EUSFNA较单纯传统影像学的灵敏度、特异度、Youden指数均高（90%、79.17%、0.69 vs 56.67%、54.17%、0.11）。结论 EUSFNA可提高诊断胰腺囊性病变的准确性，掌握超声内镜下细针穿刺操作技巧尤为重要。

ObjectiveTo investigate the diagnostic value of endoscopic ultrasonographyguided fine needle aspiration (EUSFNA) in the pancreatic cystic lesions. MethodsForm Jan 2010 to Dec 2014, the clinical data of 30 patients with pancreatic cystic disease were retrospectively reviewed including traditional imaging tests(CT、MRI、Bultrasound) and EUSFNA. 16 cases were routinely underwent liquidbased cytology(LBC) and cell blocks by EUSFNA. Through comparation with the accuracy, sensitivity, specificity and Youden index of all kinds of examination, the diagnostic value of EUSFNA was confirmed and the operation skill concluded in pancreatic cystic diseases. Results6 cases were diagnosed as pancreatic cancer, 4 cases cystadenocarcinomas,14 cases pancreatic pseudocyst, 4 cases mucinous cystadenoma and 2 cases intraductal papillary mucinous neoplasm (IPMN). The diagnostic accuracy of traditional imaging tests、EUSFNA、LBC and cell blocks were respectively 56.67%、90%、73.33%、100% (P＜0.05). Compared with traditional imaging tests, the sensitivity、specificity、Youden index of EUSFNA were higher(90%、79.17%、0.69 vs 56.67%、54.17%、0.11).The sensitivity of cell blocks was higher than LBC(100% vs 75%). ConclusionEUSFNA can improve the diagnostic accuracy of pancreatic cystic lesions and it is important to master skill of EUSFNA.