在接受胰腺手术的患者中,比较便Elastase-1和C混合甘油三酸呼吸试验
Vera Hartman1, Bart Bracke1, Thiery Chapelle1
1Department of HPB, Endocrine and Transplantation Surgery, University Hospital Antwerp, Drie Eikenstraat 655, Edegem, Belgium; University of Antwerp, Prinsstraat 13, Antwerp, Belgium.
便弹性酶-1 (FE-1) 在手术患者中过度诊断胰腺外分泌功能不足 (PEI). 13C混合甘油三醇呼吸测试 (MTGT) 是一个更可靠的诊断标准,显示与手术后FE-1缺乏一致性.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 诊断的准确性 诊断的准确性
背景情况:
- 胰腺外分泌功能缺陷 (PEI) 的最佳诊断方法正在争论中.
- 这项研究评估了便弹性酶-1 (FE-1) 与13C混合甘油酸呼吸测试 (MTGT) 对胰腺手术的患者.
研究的目的:
- 为了比较FE-1和MTGT在接受胰腺切除的患者的诊断准确度.
- 为了评估 FE-1 和 MTGT 在胰腺手术前后之间的协议.
主要方法:
- 一组249名接受胰腺切除的患者用FE-1和MTGT进行了测试.
- MTGT作为诊断PEI的参考标准.
- 使用科恩的卡帕评估了协议.
主要成果:
- 在手术前,FE-1显示PEI患病率 (39.6%) 比MTGT (25.3%) 高,公平协议 (κ = 0.27).
- 在胰腺二管切除术后,PEI的患病率增加到92.2% (FE-1) 和60% (MTGT),只有轻微的协议 (κ = 0.17).
- FE-1具有高灵敏度 (98.1%),但特异性低 (16.7%),导致错误阳性率为83.5%.
结论:
- 在胰腺外科手术患者中,FE-1和MTGT之间的一致性明显低于预期,特别是在胰腺二切除术后.
- FE-1的低特异性和高错误阳性率有助于PEI过度诊断.
- 过度诊断导致不必要的患者负担和经济成本.
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