| Objective:To investigate the diagnostic efficacy and influencing factors of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)and ultrasound-guided core needle biopsy(US-CNB)in pancreatic space-occupying lesions.Methods:A total of 171 cases of pancreatic space occupying lesions who met the inclusion criteria and were treated in the First Affiliated Hospital of Bengbu Medical College from January 2018 to June 2022 were included,including the EUS-FNA group(n=63)and the US-CNB group(n=108).The general clinical data,lesion characteristics,pancreatic duct conditions and puncture times of the two groups of patients were collected.The histopathology results of the lesion samples were used as the gold standard to analyze the factors affecting EUS-FNA and US-CNB in diagnosing pancreatic space occupying lesions.The results of smear cytology,liquid based cytology and histopathology in EUS-FNA group were compared.The general clinical data,number of puncture needles and postoperative complications between EUS-FNA and US-CNB groups were compared and analyzed to explore the diagnostic efficacy and application value of the two groups.Results:EUS-FNA was performed in 63 patients with pancreatic space-occupying lesions,with an average age of(62.83 ± 11.25)years,including 34 males and 29 females.EUS-FNA was successfully performed in these patients,with a puncture success rate of100%.There were 2 postoperative complications(3.17%).There were 55 cases(87.30%)with definite diagnosis by EUS-FNA,and 8 cases(12.70%)without definite diagnosis,of which 5 cases were finally diagnosed by pathology after operation.The diagnostic sensitivity of EUS-FNA was 91.67%(55/60),specificity was 100%(3/3),accuracy was92.06%(58/63),positive predictive value was 100%(55/55),negative predictive value was 37.50%(3/8).According to statistical analysis,the diagnostic efficacy of EUS-FNA was related to the patient’s age and lesion characteristics(P <0.05),but not to the patient’s pancreatic duct dilation,lesion site,and number of puncture needles(P >0.05).There was no statistically significant difference between the two cytological diagnostic methods and the results of histopathological diagnosis(P >0.05).A total of 108 patients with pancreatic space-occupying lesions were examined by US-CNB,with an average age of(61.30 ± 10.21)years,including 60 males and 48 females.There were 15 postoperative complications(13.89%).94 cases(87.04%)were definitely diagnosed by US-CNB,and 14 cases(12.96%)were not definitely diagnosed,of which 9 cases were finally diagnosed by pathology after surgery.The diagnostic sensitivity was 91.26%(94/103),specificity was 100%(5/5),accuracy was 91.67%(99/108),positive predictive value was 100%(94/94),and negative predictive value was35.71%(5/14).According to statistical analysis,the diagnostic efficacy of US-CNB was related to the size of the patient’s lesion and C-reactive protein(P <0.05).It was not related to the general clinical data,pancreatic duct dilation,lesion location,number of puncture needles,etc(P >0.05).There was no statistically significant difference in diagnostic efficacy between EUS-FNA and US-CNB examinations(P >0.05),but there was a statistically significant difference in the number of puncture needles and the incidence of complications(P<0.05).Conclusion:1.The lesion characteristics and age are independent factors affecting the results of EUS-FNA.The lesion size and C-reactive protein are independent factors affecting the results of US-CNB.2.The sensitivity,specificity and accuracy of EUS-FNA and US-CNB are very high,and there is no statistical difference.In contrast,EUS-FNA has fewer puncture needles and lower postoperative complications.3.The cytological examination methods have high accuracy in the qualitative diagnosis of the lesions,and has no statistical difference with the histopathological diagnosis results. |
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