医学
内镜超声
放射科
淋巴结
腺瘤
内镜超声检查
活检
病态的
内窥镜检查
内科学
作者
Chun Yan Peng,Ying Lv,Shan Shan Shen,Lei Wang,Xi Wei Ding,Xiao Ping Zou
标识
DOI:10.1111/1751-2980.12719
摘要
Objective We aimed to evaluate the efficacy of endoscopic ultrasonography (EUS) in assessing locoregionally and determining therapeutic options for ampullary adenomas and the related factors. Methods Patients undergoing EUS and surgical or endoscopic resection for biopsy‐proven ampullary adenomas between 2009 and 2016 were retrospectively analyzed. The depth of tumor invasion, intraductal extension, and regional lymph node staging evaluated by EUS were compared with post‐treatment pathological findings. Results Altogether 120 patients were enrolled in this study. The overall accuracy for EUS in T staging was 81.7%. The sensitivity and specificity of EUS for T staging were 93.9%, 45.5% for adenoma and T1, 50.0% and 96.5% for T2, 66.7% and 97.4% for T3, 50.0% and 97.5% for T4 lesions, respectively. The sensitivity, specificity, and accuracy of EUS for the diagnosis of any intraductal extension were 89.5%, 86.1%, and 86.7%, respectively. The overall accuracy of EUS for regional lymph node staging was 75.0%. The sensitivity and specificity of EUS for diagnosing N1 were 62.5% and 87.5%. By multivariate analysis no factors were found to be independently associated with EUS accuracy for tumor invasive depth. However, small lesion size (≤15 mm) and dilated duct were associated with an overestimation in intraductal extension. Conclusion EUS may be a useful diagnostic tool for selecting endoscopic or surgical treatment for ampullary adenomas.
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