Endoscopic approach to the diagnosis of pancreatic cystictumor

• 作者: Yoshiaki Kawaguchi Tetsuya Mine
• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 关键词: ENDOSCOPIC ULTRASOUND ENDOSCOPIC retrogradecholangiopancreatography ENDOSCOPIC ultrasound-needleaspiration PANCREATIC CYSTIC TUMOR CYTOLOGY
• 年，卷（期）: 2016,（2）
• 页码范围: 159-164
• 页数: 6页
• 分类号: R

摘要

Because of the aging of the population, prevalence ofmedical checkups, and advances in imaging studies, thenumber of pancreatic cystic lesions detected has increased.Once these lesions are detected, neoplastic cysts shouldbe differentiated from non-neoplastic cysts. Furthermore,because of the malignant potential of some neoplasticpancreatic cysts, further differentiation between benignand malignant cysts should be made regardless of theirsize. Although endoscopic ultrasound （EUS） has a veryhigh diagnostic performance for pancreatic cystic lesionsamong the various imaging modalities, EUS findingsalone are insufficient for the differentiation of pancreaticcysts and diagnosis of malignancy. In addition, cytologyby EUS-guided fine-needle aspiration （FNA） has a highspecificity but a low sensitivity for diagnosing malignancyin pancreatic cystic tumors. The levels of amylase, lipase,and tumor markers in pancreatic cystic fluid are consideredauxiliary parameters for diagnosis of benign and malignantcysts, and a definitive diagnosis of malignancy using theseparameters is difficult. Thus, in addition to EUS, cytologyby EUS-FNA, and cystic fluid analysis, new techniquesbased on EUS-guided through-the-needle imaging, such asconfocal laser endomicroscopy and cystoscopy, have beenexplored in recent years.