EUS-FNA对胰头钩突占位性病变诊断价值的分析

The Diagnostic Value of EUS-FNA in Occupying Lesions of Pancreatic Head Uncinate Process

摘要: 目的：探讨超声内镜引导下细针穿刺活检(endoscopic ultrasonography guided fine needle aspira-tion, EUS-FNA)对胰头钩突占位性病变的诊断价值。方法：选取2019年12月~2022年12月60例在潍坊市人民医院考虑为胰头钩突占位性病变的患者，在超声内镜引导下行细针穿刺活检，以病理结果和随访情况作为最终诊断，比较不同检查方法的诊断效能，以此评价超声内镜引导下细针穿刺活检术的诊断价值。结果：1) 60例患者中，最终确诊为恶性的为48例，良性为12例，恶性组患者的年龄、GGT、D-BIL、CA199、CEA明显高于良性组，差异有统计学意义；2) 超声内镜下呈低回声改变，伴胰管扩张，边界不清的实性肿物诊断为恶性的可能性大，差异有统计学意义；3) EUS-FNA对胰头钩突占位性病变诊断的准确性为96.67%，敏感度为95.83%，特异度为100.00%，明显高于增强CT、增强MRI等，且对实性肿瘤诊断的准确率为98.00%，灵敏度为97.50%，特异度为100.00%，高于囊性/囊实性病变；4) 病灶越大，诊断的准确性越高。结论：EUS-FNA对胰头钩突占位性病变的早期诊断价值较高，并发症少，值得推广。

Abstract: Objective: To investigate the diagnostic value of endoscopic ultrasonography-guided fine needle as-piration (EUS-FNA) in space-occupying lesions of the uncinate process of the head of the pancreas. Methods: Sixty patients who were considered as occupying lesions of the pancreatic head uncinate process in Weifang People’s Hospital from December 2019 to December 2022 were selected for fine needle puncture biopsy under endoscopic ultrasound guidance. Pathological results and follow-up were used as the final diagnosis. The diagnostic efficacy of different examination methods was com-pared, so as to evaluate the diagnostic value of fine needle puncture biopsy under endoscopic ul-trasound guidance. Results: 1) Among the 60 patients, 48 were diagnosed as malignant and 12 were benign. The age, GGT, D-BIL, CA199 and CEA of patients in the malignant group were signifi-cantly higher than those in the benign group, and the differences were statistically significant. 2) Solid masses with hypoechoic changes under endoscopic ultrasonography accompanied by pancre-atic duct dilation and unclear boundaries were more likely to be diagnosed as malignant, and the difference was statistically significant; 3) The accuracy, sensitivity and specificity of EUS-FNA were 96.67%, 95.83% and 100.00%, which were significantly higher than those of enhanced CT and en-hanced MRI. The accuracy, sensitivity and specificity of EUS-FNA in the diagnosis of solid tumors were 98.00%, 97.50% and 100.00%, respectively, higher than cystic/solid lesions; 4) The larger the lesion, the higher the diagnostic accuracy. Conclusion: EUS-FNA has high diagnostic value in the early diagnosis of pancreatic uncinate occupying lesions with fewer complications, so it is worth promoting.