[Value of cyto-puncture and of ultrasonic-guided micro-biopsy in solid tumors of the pancreas].
43 patients (29 men, 14 women, average age 64.7 years) with a solid lesion of the pancreas underwent echography-guided cytopuncture (needle 22 G, 88 mm) associated in 11 cases with microbiopsy (needle 21 G, 150 mm). The lesions were localized in the pancreatic head (n = 27), body (n = 13) and tail (n = 3). The sensitivity and specificity of cytopuncture were 81% and 100% respectively. There were 27 true positives (26 pancreatic adenocarcinomas and one metastasis of a prostatic adenocarcinoma); 10 true negatives (5 cases of calcifying chronic pancreatitis, 3 benign endocrine tumors, 2 cases of acute pancreatitis); and 6 false negatives (4 adenocarcinomas and 2 intrapancreatic cholangiocarcinomas). There were no false positives. Microbiopsy diagnosed 5 adenocarcinomas out of 9 cases biopsied and 2 benign endocrine tumors not detected by cytopuncture. Its sensitivity was thus 56% for malignant lesions and 64% for all lesions biopsied. Its specificity was 100%. There was one (= 2.5%) complication (dissemination on the needle pathway). We conclude that echography-guided cytopuncture is a simple and effective method of diagnosing solid tumors of the pancreas. Biopsy, though of lower sensitivity, probably serves to increase the specificity of cytopuncture, in the case of benign lesions in particular.
Schonenberg
P
P
Division de gastroentérologie, Hôpital cantonal, Genève.
Bastid
C
C
Guedes
J
J
Sahel
J
J
D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity; D014463:Ultrasonography
Apport de la cyto-ponction et de la micro-biopsie guidées par échographie dans la pathologie tumorale solide du pancréas.