Clinical Diagnostic Value Of Endoscopic Ultrasonography Combined With Enhanced CT In Pancreatic Cancer

BackgroundPancreatic cancer(PC)is a malignant gastrointestinal cancer originating from ductal epithelium and acinar cells of the pancreas.Early diagnosis of pancreatic cancer is difficult in clinical research,and the prognosis is very poor.Although total resection is the only effective treatment for pancreatic cancer,only 20% of newly diagnosed pancreatic cancer patients have the opportunity to undergo surgical resection for therapeutic purposes.In order to improve the survival rate and quality of life of patients,prolong the life of patients,and alleviate the pain of patients,early detection of pancreatic cancer is very important.How to detect pancreatic cancer as early as possible and assess whether the lesion has surgical indications is an urgent clinical problem.At present,the gold standard for the diagnosis of pancreatic cancer is still the final histopathological diagnosis.Enhanced CT plays an important role in the diagnosis of pancreatic cancer.In recent years,endoscopic ultrasonography(EUS)has been widely used in clinic,especially in the diagnosis and treatment of pancreatic cancer.In the special case of incomplete diagnosis,clinicians must understand the advantages and disadvantages of various pancreatic imaging methods and find the best diagnostic method so as to make diagnosis as soon as possible and obtain the best treatment and management decisions.ObjectiveThis topic aims to compare the accuracy,sensitivity and specificity of diagnosis among EUS,enhanced CT scan and EUS+ enhanced CT scan according to the final pathological diagnosis for patients suspected of pancreatic cancer,so as to provide important basis for clinical treatment.Studying the application value of EUS,enhanced CT scan and EUS combined enhanced CT in the diagnosis and evaluation of pancreatic cancer is helpful to select more useful examination methods and provide important reference data for patients to formulate individualized treatment plans.Research methods1.Subjects: Patients with pancreatic cancer considered were collected from December 2015 to January 2019 in clinical and laboratory examinations of Department of Gastroenterology and General Surgery,First Affiliated Hospital of Henan University.2.Data collection and comparison: Collect the general conditions of all participants,including gender,age,ultrasound endoscopy results and enhanced CT results.Divide the samples included in the standard into EUS group,enhanced CT group and EUS combined enhanced CT group according to the different examination methods.According to the pathological diagnosis of fine needle puncture after surgery or endoscopic ultrasonography,the results of different grouping examinations were compared and analyzed.3.Statistical method: SPSS 22.0 statistical software was used to carry out ?2 test,p < 0.05 showed that the difference was statistically significant.To compare the accuracy,sensitivity and specificity of EUS,enhanced CT and EUS combined with enhanced CT in the diagnosis of pancreatic cancer.Result1.EUS has a diagnostic accuracy of 80.9%,sensitivity of 80.5% and specificity of 83.3% for pancreatic cancer.The diagnostic accuracy,sensitivity and specificity of enhanced CT were 77.4%,78.6% and 66.7%,respectively.EUS+ enhanced CT has a diagnostic accuracy of 95.6%,sensitivity of 97.6% and specificity of 80.0% for pancreatic cancer.EUS+ enhanced CT was significantly more sensitive to pancreatic cancer than EUS and enhanced CT(P<0.05).2.The diagnostic accuracy of EUS examination for T staging of pancreatic cancer is 76.6%,and that of enhanced CT examination for T staging of pancreatic cancer is 51.6%,and that of EUS+ enhanced CT examination for T staging of pancreatic cancer is 84.4%.The accuracy of EUS+ enhanced CT in T staging was significantly higher than that of enhanced CT(P<0.05).3.EUS has a diagnostic accuracy of 68.8%,sensitivity of 52.9% and specificity of 86.7% for lymph node metastasis.The diagnostic accuracy,sensitivity and specificity of enhanced CT for lymph node metastasis were 65.2%,38.5% and 83.3%,respectively.EUS+ enhanced CT has an accuracy of 81.8%,sensitivity of 73.7% and specificity of 92.9% for lymph node metastasis.EUS+ enhanced CT is more sensitive to lymph node metastasis than enhanced CT(P>0.05).The sensitivity of EUS in the diagnosis of lymph node metastasis was significantly higher than that of enhanced CT(P<0.05).ConclusionEUS combined enhanced CT has more advantages than EUS alone and enhanced CT alone in the diagnosis of pancreatic cancer(P<0.05),which is worthy of our clinical promotion and application.EUS combined enhanced CT showed significantly higher sensitivity to pancreatic cancer than EUS combined enhanced CT.EUS combined enhanced CT is superior to enhanced CT in T staging of pancreatic cancer.The sensitivity of EUS combined with enhanced CT and EUS alone in the N staging of pancreatic cancer was significantly enhanced in both groups(P<0.05).Therefore,EUS combined with enhanced CT is of great significance for the diagnosis of pancreatic cancer.EUS combined with enhanced CT is essential for the diagnosis,localization,staging,resection and prognosis of pancreatic cancer.In addition,when EUS is performed,eus-fna can be used for histological examination to provide more information for tumor diagnosis.