经过先前的非诊断或不确定的采样后,对固体胰腺病变进行重复内镜超声波引导细针活检
Andrea Lisotti1, Anna Cominardi1,2, Maria Cristina Conti Bellocchi3
1Gastroenterology Unit, Hospital of Imola, University of Bologna, Imola, Italy.
概括
重复内超声波 (EUS) 引导的细针活检 (FNB) 在初步不确的结果后,为胰腺病变提供了高的诊断准确性. 转移到大批量中心和使用第二代针提高了诊断结果和样本的充分性.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 诊断成像 诊断成像 诊断成像
背景情况:
- 重复的内镜超声波 (EUS) 引导的组织采集是固体胰腺病变的标准,先前没有诊断结果.
- 关于重复EUS细针活检 (rEUS-FNB) 的诊断性能的数据有限.
研究的目的:
- 评估 rEUS-FNB 对于固体胰腺病变的诊断性能.
- 评估rEUS-FNB的样本充分性,敏感性,特异性和安全性.
主要方法:
- 一项针对连续接受rEUS-FNB治疗固体胰腺病变的患者 (2019-2021) 的多中心研究.
- 黄金标准包括手术病理学或恶性/良性组织学,并进行适当的后续检查.
- 诊断准确性,样本充分性,敏感性和特异性是主要和次要结局.
主要成果:
- 这项研究包括462名患者,77.0%患有恶性瘤. 整体诊断准确率为89.2%,敏感度为91.4%,特异性为81.7%.
- 高体积的中心和更大的瘤大小与改善的诊断准确性有关.
- 第二代FNB针和较大的瘤大小 (>23毫米) 显著改善了样本充分性 (94.2%).
结论:
- rEUS-FNB在非诊断性或不确的初步结果后,证明了胰腺病变的最佳诊断性能.
- 将患者转移到大量的中心可以提高诊断的准确性.
- 与标准针相比,第二代FNB针显著提高了样本的充分性.
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