The Role of CT-guided Core Needle Biopsy in Pancreatic Tumors: An Initial Evaluation in Modern Oncology.

Eduardo P Eyheremendy, Cristian A Angeramo, Patricio Méndez
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引用次数: 0

Abstract

Purpose: Neoadjuvant chemotherapy has recently become the standard of care for borderline resectable pancreatic ductal adenocarcinoma (PDAC), and there have even been numerous reports evaluating its potential benefits in resectable PDAC. However, neoadjuvant therapy first requires a histological or cytological diagnosis. This study aimed to analyze the safety and diagnostic yield of CT-guided core needle biopsy (CNB).

Material and methods: A retrospective analysis of patients with pancreatic tumor requiring a CNB during the period 2015 to 2023 were included. Biopsies were performed with an 18-20 G Tru-Core needle using a coaxial system and automatic biopsy gun. Demographics, procedural variables, postoperative outcomes, and histological results were analyzed.

Results: A total of 43 pancreatic biopsies were performed in 42 patients. The mean age was 60 years (35 to 81 y), and 24 (56%) were males. Tumors were more frequently localized in the head (42%) and body (42%) of the pancreas. The mean size of the pancreatic lesions was 53.77 mm (17 to 181 mm) and the mean number of samples per biopsy was 4 (1 to 12). Most procedures were performed via direct access (81%). No major complications were observed. Histological diagnosis was obtained in 40 (93%) patients, with a sensitivity of 93%, specificity of 100% and an overall accuracy rate of 93%. The probability of performing a molecular diagnostic test increased with the year of biopsy (OR 3.34, 95% CI 1.33-8.40, P=0.01).

Conclusions: CNB is an efficient and safe method for obtaining high-quality material. This approach could be essential as molecular profiling continues to improve the diagnosis, prognosis, and treatment of PDAC.

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CT 引导下核心针活检在胰腺肿瘤中的作用:现代肿瘤学的初步评估。
目的:新辅助化疗最近已成为可切除胰腺导管腺癌(PDAC)的标准治疗方法,甚至有许多报告评估了新辅助化疗对可切除PDAC的潜在益处。然而,新辅助治疗首先需要组织学或细胞学诊断。本研究旨在分析CT引导下核心针活检(CNB)的安全性和诊断率:回顾性分析了2015年至2023年期间需要进行CNB的胰腺肿瘤患者。活检使用 18-20 G Tru-Core 穿刺针,使用同轴系统和自动活检枪进行。对人口统计学、手术变量、术后结果和组织学结果进行了分析:结果:42 名患者共进行了 43 例胰腺活检。平均年龄为 60 岁(35 至 81 岁),男性 24 人(56%)。肿瘤多位于胰腺头部(42%)和胰腺体部(42%)。胰腺病变的平均大小为 53.77 毫米(17 至 181 毫米),每次活检的平均样本数为 4 个(1 至 12 个)。大多数手术都是通过直接入路进行的(81%)。未发现重大并发症。40例(93%)患者获得了组织学诊断,敏感性为93%,特异性为100%,总体准确率为93%。进行分子诊断检测的概率随着活检年份的增加而增加(OR 3.34,95% CI 1.33-8.40,P=0.01):CNB是一种高效、安全的获取高质量材料的方法。结论:CNB 是一种高效、安全的获取高质量材料的方法,随着分子图谱分析不断改进 PDAC 的诊断、预后和治疗,这种方法将变得至关重要。
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来源期刊
CiteScore
2.00
自引率
10.00%
发文量
103
审稿时长
3-8 weeks
期刊介绍: Surgical Laparoscopy Endoscopy & Percutaneous Techniques is a primary source for peer-reviewed, original articles on the newest techniques and applications in operative laparoscopy and endoscopy. Its Editorial Board includes many of the surgeons who pioneered the use of these revolutionary techniques. The journal provides complete, timely, accurate, practical coverage of laparoscopic and endoscopic techniques and procedures; current clinical and basic science research; preoperative and postoperative patient management; complications in laparoscopic and endoscopic surgery; and new developments in instrumentation and technology.
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