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RISS 인기검색어
- 검색키워드
- 저자 : Saimon Takada (검색결과 2 건)
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Yuki Fujii,Kazuyuki Matsumoto,Hironari Kato,Yosuke Saragai,Saimon Takada,Sho Mizukawa,Shinichiro Muro,Daisuke Uchida,Takeshi Tomoda,Shigeru Horiguchi,Noriyuki Tanaka,Hiroyuki Okada 대한소화기내시경학회 2019 Clinical Endoscopy Vol.52 No.5
Background/Aims: This study aimed to examine the diagnostic ability of endoscopic ultrasonography (EUS) for major vascularinvasion in pancreatic cancer and to evaluate the relationship between EUS findings and pathological distance. Methods: In total, 57 consecutive patients who underwent EUS for pancreatic cancer before surgery were retrospectively reviewed. EUSimage findings were divided into four types according to the relationship between the tumor and major vessel (types 1 and 2: invasion,types 3 and 4: non-invasion). We also compared the EUS findings and pathologically measured distances between the tumors andevaluated vessels. Results: The sensitivity, specificity, and accuracy of EUS diagnosis for vascular invasion were 89%, 92%, and 91%, respectively, in theveins and 83%, 94%, and 93%, respectively, in the arteries. The pathologically evaluated distances of cases with type 2 EUS findings weresignificantly shorter than those of cases with type 3 EUS findings in both the major veins (median [interquartile range], 96 [0–742] µmvs. 2,833 [1,076–5,694] µm, p=0.012) and arteries (623 [0–854] µm vs. 3,097 [1,396–6,000] µm, p=0.0061). All cases with a distance of≥1,000 µm between the tumors and main vessels were correctly diagnosed. Conclusions: Tumors at a distance ≥1,000 µm from the main vessels were correctly diagnosed by EUS.
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Kazuyuki Matsumoto,Hironari Kato,Shigeru Horiguchi,Takeshi Tomoda,Akihiro Matsumi,Yuki Ishihara,Yosuke Saragai,Saimon Takada,Shinichiro Muro,Daisuke Uchida,Hiroyuki Okada 거트앤리버 소화기연관학회협의회 2020 Gut and Liver Vol.14 No.5
Background/Aims: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA; EUS-FNA) allows for diagnostic tissue specimens from various regions to be analyzed. However, diagnosing recurrent pancreaticobiliary cancer after surgery is sometimes difficult. We evaluated the efficacy of EUS-FNA in the diagnosis of local recurrence of pancreaticobiliary cancer and analyzed the factors associated with falsenegative results. Methods: Fifty-one consecutive patients who underwent EUS-FNA due to suspected recurrence of pancreaticobiliary cancer after surgery in an academic center were retrospectively analyzed. The criteria for EUS-FNA were a resected margin or remnant pancreas mass, round swollen lymph node (≥10 mm in diameter), and soft-tissue enhancement around a major artery. Patients with suspected liver metastasis or malignant ascites were excluded. Results: Thirty-nine of the 51 patients had pancreatic cancer; the remaining 12 had biliary cancer. The target sites for EUS-FNA were the soft tissue around a major artery (n=22, 43%), the resected margin or remnant pancreas (n=12, 24%), and the lymph nodes (n=17, 33%). The median size of the suspected recurrent lesions was 15 mm (range, 8 to 40 mm). The overall sensitivity, specificity and accuracy of EUS-FNA for the diagnosis of recurrence was 84% (32/38), 100% (13/13), and 88% (45/51), respectively. FNA of the soft tissue around major arteries (odds ratio, 8.23; 95% confidence interval, 1.2 to 166.7; p=0.033) was significantly associated with a falsenegative diagnosis in the multivariate analysis. Conclusions: EUS-FNA is useful for diagnosing recurrent cancer, even after pancreaticobiliary surgery. The diagnoses of recurrence at soft-tissue sites should be interpreted with caution.
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