超声引导经皮穿刺活检与CA19-9联合检测对胰腺占位性病变的诊断价值

目的 :探讨超声引导下经皮穿刺活检与CA19 9联合检测对胰腺占位性病变的诊断价值。　方法 :对 30例超声检查怀疑胰腺占位性病变者行血清学CA19 9检测 ,并在体表B超引导下 ,用 18G或 19G切割活检针和 2 2G抽吸活检针行组织学和细胞学检查。　结果 :CA19 9诊断的敏感性为 92 % ,特异性 5 0 % ,准确性 92 %。超声引导经皮穿刺活检 30例患者总穿刺成功率为 93.3% (2 8/ 30 ) ,2 6例胰腺癌患者穿刺成功率为 92 .3% (2 4 / 2 6 ) ,活检阳性者 2 3例 ,其诊断敏感性为 88.4 % ,特异性 10 0 % ,准确性 88.4 %。CA19 9与超声引导经皮穿刺活检联合检测对胰腺占位性病变诊断的敏感性为 92 .3%、特异性 10 0 %、准确性 92 .3% ,与单行超声引导经皮穿刺活检比较有显著差异 (P <0 .0 5 ) ,而且对患者的治疗及预后有指导意义。穿刺结束后除个别患者有轻微腹痛外 ,无一例出现出血、胰瘘及胃穿孔等并发症。　结论 :体表B超引导下经皮穿刺与CA19 9联合检测对胰腺占位性病变诊断的敏感性、特异性、准确性较单一检测高 ,而且对患者的治疗及预后有一定价值 ,是一种安全、可靠的方法。

Significance of ultrasonography guided biopsy in pancreatic mass

Objectives:To investigate the significance of ultrasonography guided biopsy and CA19 9 in pancreatic mass. Methods:Guided by ultrasonography, thirty pancreatic masses biopsy were obtained with 18G or 19G and 22G autobiopsy device. Twenty six patients had pancreatic cancer (PC) and two had chronic pancreatitis (CP). Results:The successful rate of puncture was 93.3% , the successful rate of puncture in patients with pancreatic cancer was 92.3% .Sensitivity, specificity and accuracy were 88.4 %, 100% and 88.4% respectively. The successful rate of puncture in patients with chronic pancreatic was 100% , Sensitivity, specificity and accuracy of CA19 9 in patients with pancreatic mass were 92%, 50% and 92% respectively. Sensitivity, specificity and accuracy of ultrasonography guided biopsy and CA19 9 in pancreatic mass were 92.3%, 100% and 92.3% respectively. Conclusions: CA19 9 and biopsy gueded by ultrasonography with autobiopsy device is a useful tool for differential diagnosis of malignant and benign pancreatic mass.