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目的探讨术前诊断为胰腺癌术中细针穿刺细胞学(FNAC)检查阴性结果病例的临床意义和提高诊断准确性的方法。方法回顾性分析1995年12月至2006年6月中国协和医科大学肿瘤医院术前诊断为胰腺癌,术中FNAC结果阴性的33例病人的临床特点、影像表现、实验室检查结果和随访资料。结果33例均获得随访,时间3个月至8年,其中30例为真阴性病例,肿物为慢性肿块型胰腺炎所致;3例为假阴性病例,术后出现肿块增大,肿瘤多发转移。结论慢性胰腺炎(CP)是出现阴性结果的主要因素,肿瘤体积大小、生长方式和术者取材技术决定FNAC的准确性。应提高对慢性胰腺炎临床特点的认识及术前诊断的准确性,改进穿刺取材和制片技术可以降低假阴性率。
Objective To investigate the clinical significance of preoperative diagnosis of pancreatic carcinoma with negative result of FNAC and improve the diagnostic accuracy. Methods The clinical features, imaging findings, laboratory findings and follow-up data of 33 patients with pancreatic cancer preoperatively diagnosed between December 1995 and June 2006 in Cancer Hospital of Peking Union Medical College were reviewed. Results All 33 cases were followed up from 3 months to 8 years. Among them, 30 cases were true negative cases. The tumor was caused by chronic lump-type pancreatitis. 3 cases were false-negative cases. After the operation, tumors increased and tumors developed frequently. Transfer. Conclusions Chronic pancreatitis (CP) is the main cause of negative results. The size of the tumor, the growth pattern, and the technique used by the surgeon determine the accuracy of FNAC. The understanding of the clinical features of chronic pancreatitis and the accuracy of preoperative diagnosis should be improved. Improvements in puncture and drawing techniques and production techniques can reduce the false-negative rate.