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目的:通过超声引导穿刺活检技术的应用,为胰腺癌的早期病理诊断开创了一个安全有效的新途径,并比较18G粗针及21G细针穿刺活检的临床应用价值。方法:应用粗针及细针经超声引导下对113例可疑胰腺癌的患者穿刺活检,活检取出的组织能作出明确组织病理学诊断的为取材满意,以手术后病理诊断或随访6个月～1年的结果为最后诊断。结果:113例中,107例取材满意,能作出明确组织病理学诊断,穿刺获得组织学诊断率为94.7%。粗针活检46例,细针活检67例,两种针型取材满意率间的比较及就良恶性诊断,粗、细针间的敏感性、特异性、准确性、并发症发生率比较均无显著性差异(P>0.05);细针有2例假阴性,粗针无,两种针型间比较无显著性差异(P>0.05)。结论:超声引导胰腺病变穿刺活检,技术方法简便,病理诊断阳性率高,对确定诊断有重要意义。18G粗针较21G细针穿刺同样安全,并且获取标本较完整,取材量大,有利于对病变组织结构的观察,故应值得提倡。
OBJECTIVE: To establish a safe and effective new approach for the early pathological diagnosis of pancreatic cancer through the application of ultrasound-guided biopsy, and to compare the clinical value of 18G needle and 21G needle aspiration biopsy. Methods: Thirty-three patients with suspected pancreatic cancer underwent needle biopsy under the guidance of thick needle and fine needle. The tissue removed by biopsy was able to make definite histopathological diagnosis for satisfactory results. After pathological diagnosis or follow-up of 6 months ~ The result of 1 year is the final diagnosis. Results: Among the 113 cases, 107 cases were satisfactorily drawn, and a clear histopathological diagnosis could be made. The histological diagnosis rate of the puncture was 94.7%. 46 cases of thick needle biopsy and 67 cases of fine needle biopsy. The comparisons of satisfactory rates between the two acupuncture points and the comparison of the sensitivity, specificity, accuracy and complication rates between benign and malignant ones (P> 0.05). There were two false negatives in fine needles and no thick needles. There was no significant difference between the two needle types (P> 0.05). Conclusion: Ultrasound guided pancreatic lesion biopsy, the technique is simple, the positive rate of pathological diagnosis is high, which is of great significance for the diagnosis. 18G thick needle than 21G fine needle aspergillus puncture the same security, and access to specimens more complete, large amount of material, is conducive to the observation of the lesion structure, it should be promoted.