超声内镜引导下22G与25G细针对胰腺导管腺癌病理学诊断效能的对比

Comparison of 22G and 25G Needles for EUS-FNA Diagnosis of Pancreatic Ductal Adenocarcinoma

摘要: 目的：比较超声内镜引导下细针穿刺吸取(EUS-FNA)中22G与25G穿刺针在胰腺导管腺癌(PDAC)病理学诊断中的诊断效能及成功率。方法：回顾性分析119例接受EUS-FNA并最终诊断为PDAC的患者，根据穿刺针型号分为22G组(n = 91)与25G组(n = 28)。分别比较两组在组织条、液基细胞学及细胞涂片三种取材方式下的诊断敏感性、阴性预测值及诊断成功率。结果：在不同取材方式中，22G针与25G针的诊断敏感性及阴性预测值总体相当。组织条、液基及细胞涂片取材的诊断成功率在两组间差异均无统计学意义；但总体诊断成功率22G针显著高于25G针(90.11% vs 71.43%, P = 0.026)。肿瘤大小在FNA阳性患者中显著大于FNA阴性患者(P < 0.001)。结论：22G与25G穿刺针在PDAC的EUS-FNA诊断效能相近，但22G针在总体诊断成功率方面具有一定优势。

Abstract: Objective: To compare the diagnostic performance and diagnostic success rates of 22-gauge (22G) versus 25-gauge (25G) needles in endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for pancreatic ductal adenocarcinoma (PDAC). Methods: A retrospective analysis was conducted on 119 patients who underwent EUS-FNA and were ultimately diagnosed with PDAC. Patients were divided into a 22G group (n = 91) and a 25G group (n = 28) according to the needle size used. Diagnostic sensitivity, negative predictive value, and diagnostic success rate were compared between the two groups across three sampling methods: tissue core specimens, liquid-based cytology, and conventional cytology smears. Results: Across different sampling methods, the diagnostic sensitivity and negative predictive value of the 22G and 25G needles were generally comparable. There were no statistically significant differences in diagnostic success rates between the two groups for tissue core specimens, liquid-based cytology, or cytology smears. However, the overall diagnostic success rate was significantly higher in the 22G group than in the 25G group (90.11% vs 71.43%, P = 0.026). Tumor size was significantly larger in FNA-positive patients than in FNA-negative patients (P < 0.001). Conclusions: The 22G and 25G needles demonstrate comparable diagnostic performance in EUS-FNA for PDAC; however, the 22G needle is associated with a higher overall diagnostic success rate.