超声引导穿刺活检诊断胰腺部肿瘤

目的:通过超声引导穿刺活检技术的应用,为胰腺癌的早期病理诊断开创了一个安全有效的新途径,并比较18G粗针及21G细针穿刺活检的临床应用价值。方法:应用粗针及细针经超声引导下对113例可疑胰腺癌的患者穿刺活检,活检取出的组织能作出明确组织病理学诊断的为取材满意,以手术后病理诊断或随访6个月~1年的结果为最后诊断。结果:113例中,107例取材满意,能作出明确组织病理学诊断,穿刺获得组织学诊断率为94.7%。粗针活检46例,细针活检67例,两种针型取材满意率间的比较及就良恶性诊断,粗、细针间的敏感性、特异性、准确性、并发症发生率比较均无显著性差异(P>0.05);细针有2例假阴性,粗针无,两种针型间比较无显著性差异(P>0.05)。结论:超声引导胰腺病变穿刺活检,技术方法简便,病理诊断阳性率高,对确定诊断有重要意义。18G粗针较21G细针穿刺同样安全,并且获取标本较完整,取材量大,有利于对病变组织结构的观察,故应值得提倡。

Diagnosis of pancreatic carcinoma by the technology of US-guided biopsy

Objective:To initiate a new,safe and effective method for pathologic diagnosis of early pancreatic carcinoma by using the technology of US-guided percutaneous biopsy,and to compare the clinical usefulness of 18G core(18G)needle and fine (21G)needle in biopsy.Methods:Biopsy under ultrasonic guidance by core(18G)needle and fine(21G)needle was performed in113patients with suspected pancreatic carcinoma .A biopsy was considered successful if a specific benign or ma-lignant diagnosis was rendered by the pathologist.The final diagnosis was made by pathology diagnosis after operation or the result of follow-up for 6months to one year.Results:There are107satisfied material in113cases,from which we get defi-nite histologic diagnosis,reaching a94.7%accuracy by biopsy.We use core needle (18G)on46patients while fine(21G)needle on67patients.There is no significant difference between the two types of needles in the eligibility of sampling,the sensitivity,the specificity,the accuracy on diagnosis and the complication rates.There are2false negative for fine needle biopsy while none for core needles.There is no significant difference between the two types of needles.Con clu sions:For US-guided percutaneous biopsy of pancreatic carcinoma ,the method is handy and the accuracy of the pathologic diagnosis is high,so it is significant for definite histologic diagnosis.In comparison with21G fine needle,18G core needle is also safe,and it can draw relativity full and bigger specimen,for better observing the tissue structure.This technology is worth recommend-ing.