Departmental Bulletin Paper 当院での膵手術症例における術前細胞診・組織診の現状

赤堀, 浩也  ,  飯田, 洋也  ,  北村, 直美  ,  清水, 智治  ,  仲, 成幸  ,  稲富, 理  ,  馬場, 重樹  ,  安藤, 朗  ,  九嶋, 亮治  ,  谷, 眞至

30 ( 1 )  , pp.119 - 123 , 2017-05-15 , 滋賀医科大学雑誌編集委員会
Early and accurate diagnosis is essential for improving the efficacy of treatment in patients with pancreatic cancer. The aim of this study was to evaluate the usefulness of cytological examination during retrograde cholangiopancreatography (ERCP) and tissue diagnosis by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in our hospital. Between April 2011 and April 2016, 70 patients (58 cases in invasive ductal carcinoma) were performed pancreatic surgery for pancreatic solid tumor. Sensitivity and specificity were 89 and 67% of the ERCP cytology, 80% and 75% of the EUS-FNA, respectively. Post-ERCP pancreatitis occurred in 2 of 33 (6%) patients. The tumors less than 2cm in diameter accounted for 12% of the invasive ductal carcinomas examined, and all of them were greater than 10 mm in diameter. In the present study, high-sensitivity cancer detection was limited to larger-sized, advanced-stage cancers in ERCP cytology, whereas the sensitivity was commonly high irrespective of tumor sizes or stages in EUS-FNA method. In conclusion, preoperative cytological and histological diagnosis using ERCP and EUS were performed safety and effectively in our hospital. Higher-sensitivity diagnosis of small pancreatic cancer, especially of less than 10 mm in diameter may be a future challenge.

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