在内镜超声引导下对可切除胰腺恶性肿瘤患者进行细针活检

Ming-Sheng Chien, Ching-Chung Lin, Jian‐Han Lai
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摘要

临床医生经常使用内窥镜超声波检查胰腺肿瘤。当内镜医师进行这种检查并发现肿瘤无法切除时,随后会进行细针活检以进行组织确认。但是,如果认为肿瘤可以切除,是否有必要在术前进行细针活检仍有争议。因此,我们对 2020 年至 2022 年期间接受内镜超声引导下细针活检或抽吸术(EUS-FNB 或 FNA)的单中心胰腺肿瘤患者队列进行了回顾性分析。这项研究的重点是确诊为可切除恶性胰腺肿瘤的患者。排除标准包括确诊为胰腺良性病变的患者和肿瘤无法切除的患者。共有 68 名患者参与了这项研究。组织学检查显示,胰腺腺癌是最主要的肿瘤类型(42 例,61.8%),其次是神经内分泌肿瘤(22 例,32.3%)和转移瘤(4 例,5.9%)。值得注意的是,17 名患者有其他癌症病史,其中 23.5% 被诊断为转移性肿瘤,而非原发性胰腺癌。因此,对于可切除胰腺肿瘤且有癌症病史的患者,EUS-FNA/FNB 是区分原发性和转移性肿瘤的关键。
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Endoscopic Ultrasonography-Guided Fine-Needle Biopsy for Patients with Resectable Pancreatic Malignancies
Clinicians often use endoscopic ultrasonography to survey pancreatic tumors. When endoscopists conduct this examination and find the tumor to be unresectable, a fine-needle biopsy is subsequently performed for tissue confirmation. However, if the tumor is deemed resectable, the necessity of a pre-operative fine-needle biopsy remains debatable. Therefore, we performed a retrospective analysis of a single-center cohort of patients with pancreatic tumors who underwent an endoscopic ultrasound-guided fine-needle biopsy or aspiration (EUS-FNB or FNA) between 2020 and 2022. This study focused on patients diagnosed with resectable malignant pancreatic tumors. The exclusion criteria included individuals diagnosed with benign pancreatic lesions and those with unresectable tumors. A total of 68 patients were enrolled in this study. Histological examination revealed that pancreatic adenocarcinoma was the predominant type of tumor (n = 42, 61.8%), followed by neuroendocrine tumors (n = 22, 32.3%), and metastasis (n = 4, 5.9%). Notably, 17 patients had a history of other cancers, with 23.5% being diagnosed with a metastatic tumor rather than primary pancreatic cancer. Therefore, EUS-FNA/FNB is crucial in patients with a resectable pancreatic tumor and a history of cancer to differentiate between a primary and a metastatic tumor.
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