Introduction: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) are currently recommended for the pathologic diagnosis of pancreatic solid lesions (PSLs). The application of contrast-enhanced endoscopic ultrasound (ECEUS) could aid the endoscopist during an FNA and/or FNB procedure. CEUS is indeed able to better differentiate the pathologic tissue from the surrounding healthy pancreatic parenchyma and to detect necrotic areas and vessels. Objectives: Our objective was to evaluate if ECEUS could reduce the number of needle passes and side effects and increase the diagnostic efficacy of FNA and/or FNB. Methods: A comprehensive literature search of clinical studies was performed to explore if ECEUS-FNA or FNB could increase diagnostic accuracy and reduce the number of needle passes and adverse effects compared to standard EUS-FNA or FNB. In accordance with the study protocol, a qualitative and quantitative analysis of the evidence was planned. Results: The proportion of established diagnoses of ECEUS was 90.9% compared to 88.3% of EUS, with no statistically significant difference (p= 0.14). The diagnosis was made through a single step in 70.9% of ECEUS patients and in 65.3% of EUS patients, without statistical significance (p= 0.24). The incidence of adverse reactions was substantially comparable across both groups (p= 0.89). Conclusion: ECEUS-FNA and FNB do not appear superior to standard EUS-FNA and FNB for the diagnosis of pancreatic lesions.
引言：目前推荐采用超声内镜引导下细针穿刺抽吸术（EUS-FNA）和超声内镜引导下细针活检术（EUS-FNB）对胰腺实性病变进行病理诊断。增强超声内镜（ECEUS）的应用可在FNA和/或FNB操作过程中为内镜医师提供辅助。CEUS确实能够更好地区分病变组织与周围正常胰腺实质，并检测坏死区域及血管。目的：本研究旨在评估ECEUS是否能减少穿刺次数及副作用，并提高FNA和/或FNB的诊断效能。方法：通过全面检索临床研究文献，探讨相较于标准EUS-FNA或FNB，ECEUS引导下的FNA或FNB是否能提高诊断准确率、减少穿刺次数及降低不良反应发生率。根据研究方案，计划对证据进行定性与定量分析。结果：ECEUS的确诊率为90.9%，而标准EUS为88.3%，两者无统计学显著差异（p=0.14）。70.9%的ECEUS患者和65.3%的EUS患者通过单次穿刺即获得诊断，无统计学显著性（p=0.24）。两组不良反应发生率基本相当（p=0.89）。结论：对于胰腺病变的诊断，ECEUS引导下的FNA与FNB并未显示出优于标准EUS-FNA和FNB的效果。
肿瘤(癌症)患者之家