重复超声内镜引导细针穿刺诊断胰腺实性病变的研究进展

Research progress in the diagnosis of pancreatic solid lesions by repeated endoscopic ultrasound‑guided fine‑needle aspiration/biopsy

摘要:

超声内镜引导细针穿刺抽吸/活检术（endoscopic ultrasound‑guided fine‑needle aspiration/biopsy，EUS‑FNA/FNB）是目前获取胰腺实性病变组织学诊断的首选技术。尽管EUS‑FNA/FNB的诊断准确率超过90%，但标本充分性不足或病理结果不确定的情况仍不可避免。国内外均有指南建议在第1次穿刺结果不能明确诊断时考虑第2次穿刺，通过重复穿刺明确诊断，能够使良性病变避免不必要的手术，恶性病变避免漏诊。本文就重复穿刺的诊疗现状、研究进展及阳性率影响因素进行了综述。

Abstract:

Endoscopic ultrasound-guided fine needle aspiration/biopsy (EUS-FNA/B) is currently the preferred technique for obtaining histological diagnosis of pancreatic solid lesions (SPL). Although the diagnostic accuracy of EUS-FNA/B exceeds 90%, the insufficiency of specimen adequacy or uncertain pathological results is still inevitable. Both domestic and international guidelines recommend considering a second EUS-FNA/B when the first EUS-FNA/B result cannot provide a clear diagnosis. Repeated EUS-FNA/B can avoid unnecessary surgery for benign lesions and missed diagnoses for malignant lesions through a definitive diagnosis. This article reviews the current status of diagnosis and treatment, research progress, and factors affecting the positive rate of repeated EUS-FNA/B.