超声内镜技术在胰腺癌诊断和治疗中的应用价值
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摘要
胰腺癌恶性程度极高,其诊断和治疗一直是临床工作的难点。螺旋CT、磁共振成像(magnetic resonance imaging,MRI)和超声内镜(endoscopicultrasound,EUS)是诊断胰腺癌的重要工具。随着EUS技术的不断完善,其在胰腺癌诊断中的作用和价值逐渐得到体现,特别是EUS引导下细针穿刺(EUS-guided fine needle aspiration,EUS-FNA),是目前获取胰腺病理的重要手段。此外,EUS在胰腺癌治疗中的地位也日益突出,EUS弹性成像(EUS elastography,EUS-EG)及造影增强EUS(contrast-enhancedEUS,CE-EUS)可以指导内科用药,EUS引导下的局部治疗也是胰腺癌综合治疗的重要组成部分。因此,该文回顾和评估了EUS技术在胰腺癌诊断和治疗中的价值,为EUS在胰腺癌中的应用提供参考。
With a high degree of malignancy, pancreatic adenocarcinoma is a difficulty in clinical work. Multislice spiral CT, magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are important diagnostic methods for pancreatic adenocarcinoma. With the continuous improvement of EUS technology, the value of EUS technique in diagnosis of pancreatic adenocarcinoma is gradually increased, especially EUS-guided fine needle aspiration (EUS-FNA), an important method for pancreatic biopsy. In addition, EUS also plays a key role in the treatment of pancreatic adenocarcinoma. EUS elastography (EUSEG) and contrast-enhanced EUS (CE-EUS) can guide clinical administration of medication. EUS-guided therapy is also an important component in comprehensive treatment of pancreatic adenocarcinoma. Therefore, we reviewed and evaluated the role of EUS in the diagnosis and treatment of pancreatic adenocarcinoma.
With a high degree of malignancy, pancreatic adenocarcinoma is a difficulty in clinical work. Multislice spiral CT, magnetic resonance imaging (MRI) and endoscopic ultrasound (EUS) are important diagnostic methods for pancreatic adenocarcinoma. With the continuous improvement of EUS technology, the value of EUS technique in diagnosis of pancreatic adenocarcinoma is gradually increased, especially EUS-guided fine needle aspiration (EUS-FNA), an important method for pancreatic biopsy. In addition, EUS also plays a key role in the treatment of pancreatic adenocarcinoma. EUS elastography (EUSEG) and contrast-enhanced EUS (CE-EUS) can guide clinical administration of medication. EUS-guided therapy is also an important component in comprehensive treatment of pancreatic adenocarcinoma. Therefore, we reviewed and evaluated the role of EUS in the diagnosis and treatment of pancreatic adenocarcinoma.
引文
[1]SIEGEL R L,MILLER K D,JEMAL A.Cancer statistics,2018[J].CA Cancer J Clin,2018,68(1):7-30.
[2]张师容,靳伟,刘亮,等.2017年胰腺癌基础研究及诊疗新进展[J].中国癌症杂志,2018,28(1):1-10.
[3]刘玉美,杨秀疆.超声内镜对胰腺小肿瘤的诊断价值[J].中国癌症杂志,2017,27(3):233-236.
[4]FABBRI C,LUIGIANO C,MAIMONE A,et al.Endoscopic ultrasound-guided fine-needle biopsy of small solid pancreatic lesions using a 22-gauge needle with side fenestration[J].Surg Endosc,2015,29(6):1586-1590.
[5]XU M M,SETHI A.Diagnosing biliary malignancy[J].Gastrointest Endosc Clin N Am,2015,25(4):677-690.
[6]IGNEE A,JENSSEN C,ARCIDIACONO P G,et al.Endoscopic ultrasound elastography of small solid pancreatic lesions:a multicenter study[J].Endoscopy,2018,50(11):1071-1079.
[7]ISHIKAWA T,HIROOKA Y,KAWASHIMA H,et al.Multiphase evaluation of contrast-enhanced endoscopic ultrasonography in the diagnosis of pancreatic solid lesions[J].Pancreatology,2018,18(3):291-297.
[8]HANADA K,OKAZAKI A,HIRANO N,et al.Effective screening for early diagnosis of pancreatic cancer[J].Best Pract Res Clin Gastroenterol,2015,29(6):929-939.
[9]HARINCK F,KONINGS I C,KLUIJT I,et al.A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals[J].Gut,2016,65(9):1505-1513.
[10]GHEONEA D I,STREBA C T,CIUREA T,et al.Quantitative low mechanical index contrast-enhanced endoscopic ultrasound for the differential diagnosis of chronic pseudotumoral pancreatitis and pancreatic cancer[J].BMC Gastroenterol,2013,13:2.
[11]KONGKAM P,LAKANANURAK N,NAVICHARERN P,et al.Combination of EUS-FNA and elastography(strain ratio)to exclude malignant solid pancreatic lesions:A prospective single-blinded study[J].J Gastroenterol Hepatol,2015,30(11):1683-1689.
[12]CARRARA S,DI L M,GRIZZI F,et al.EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions[J].Gastrointest Endosc,2018,87(6):1464-1473.
[13]OKASHA H,ELKHOLY S,EL-SAYED R,et al.Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions[J].World J Gastroenterol,2017,23(32):5962-5968.
[14]LUZ L P,AL-HADDAD M A,SEY M S,et al.Applications of endoscopic ultrasound in pancreatic cancer[J].World JGastroenterol,2014,20(24):7808-7818.
[15]LEE T Y,CHEON Y K,SHIM C S.Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating solid lesions of the pancreas:a single-center experience in Korea[J].Gut Liver,2013,7(5):599-604.
[16]LI X Z,SONG J,SUN Z X,et al.Diagnostic performance of contrast-enhanced ultrasound for pancreatic neoplasms:a systematic review and meta-analysis[J].Dig Liver Dis,2018,50(2):132-138.
[17]YAMASHITA Y,KATO J,UEDA K,et al.Contrast-enhanced endoscopic ultrasonography for pancreatic tumors[J].Biomed Res Int,2015,2015:491782.
[18]ZHANG S,DEFRIAS D V,ALASADI R,et al.Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA):experience of an academic centre in the USA[J].Cytopathology,2010,21(1):35-43.
[19]PARK J K,LEE Y J,LEE J K,et al.KRAS mutation analysis of washing fluid from endoscopic ultrasound-guided fine needle aspiration improves cytologic diagnosis of pancreatic ductal adenocarcinoma[J].Oncotarget,2017,8(2):3519-3527.
[20]KONGKAM P,ANG T L,VU C K,et al.Current status on the diagnosis and evaluation of pancreatic tumor in Asia with particular emphasis on the role of endoscopic ultrasound[J].J Gastroenterol Hepatol,2013,28(6):924-930.
[21]KAMATA K,KITANO M,OMOTO S,et al.New endoscopic ultrasonography techniques for pancreaticobiliary diseases[J].Ultrasonography,2016,35(3):169-179.
[22]SHI S,LIANG C,XU J,et al.The strain ratio as obtained by endoscopic ultrasonography elastography correlates with the stroma proportion and the prognosis of local pancreatic cancer[J].Ann Surg,2018.[Epub ahead of print]
[23]TIRIAC H,BUCOBO J C,TZIMAS D,et al.Successful creation of pancreatic cancer organoids by means of EUS-guided fine-needle biopsy sampling for personalized cancer treatment[J].Gastrointest Endosc,2018,87(6):1474-1480.
[24]MINAGA K,TAKENAKA M,KAMATA K,et al.Alleviating pancreatic cancer-associated pain using endoscopic ultrasound-guided neurolysis[J].Cancers(Basel),2018,10(2):E50.
[25]LEVY M J,ALBERTS S R,BAMLET W R,et al.EUS-guided fine-needle injection of gemcitabine for locally advanced and metastatic pancreatic cancer[J].Gastrointest Endosc,2017,86(1):161-169.
[26]HOLT B A,HAWES R,HASAN M,et al.Biliary drainage:role of EUS guidance[J].Gastrointest Endosc,2016,83(1):160-165.
[27]BANG J Y,NAVANEETHAN U,HASAN M,et al.Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer:a randomized trial (with videos)[J].Gastrointest Endosc,2018,88(1):9-17.
[28]SCOPELLITI F,PEA A,CONIGLIARO R,et al.Technique,safety,and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer[J].Surg Endosc,2018.[Epub ahead of print]
[29]JAVED S,BHUTANI M S.Endoscopic ultrasound-guided radiation therapy in pancreatic cancer[J].Minerva Gastroenterol Dietol,2013,59(4):377-386.
[30]DEWITT J M,SANDRASEGARAN K,O’NEIL B,et al.Phase1 study of EUS-guided photodynamic therapy for locally advanced pancreatic cancer[J].Gastrointest Endosc,2018.[Epub ahead of print]
[2]张师容,靳伟,刘亮,等.2017年胰腺癌基础研究及诊疗新进展[J].中国癌症杂志,2018,28(1):1-10.
[3]刘玉美,杨秀疆.超声内镜对胰腺小肿瘤的诊断价值[J].中国癌症杂志,2017,27(3):233-236.
[4]FABBRI C,LUIGIANO C,MAIMONE A,et al.Endoscopic ultrasound-guided fine-needle biopsy of small solid pancreatic lesions using a 22-gauge needle with side fenestration[J].Surg Endosc,2015,29(6):1586-1590.
[5]XU M M,SETHI A.Diagnosing biliary malignancy[J].Gastrointest Endosc Clin N Am,2015,25(4):677-690.
[6]IGNEE A,JENSSEN C,ARCIDIACONO P G,et al.Endoscopic ultrasound elastography of small solid pancreatic lesions:a multicenter study[J].Endoscopy,2018,50(11):1071-1079.
[7]ISHIKAWA T,HIROOKA Y,KAWASHIMA H,et al.Multiphase evaluation of contrast-enhanced endoscopic ultrasonography in the diagnosis of pancreatic solid lesions[J].Pancreatology,2018,18(3):291-297.
[8]HANADA K,OKAZAKI A,HIRANO N,et al.Effective screening for early diagnosis of pancreatic cancer[J].Best Pract Res Clin Gastroenterol,2015,29(6):929-939.
[9]HARINCK F,KONINGS I C,KLUIJT I,et al.A multicentre comparative prospective blinded analysis of EUS and MRI for screening of pancreatic cancer in high-risk individuals[J].Gut,2016,65(9):1505-1513.
[10]GHEONEA D I,STREBA C T,CIUREA T,et al.Quantitative low mechanical index contrast-enhanced endoscopic ultrasound for the differential diagnosis of chronic pseudotumoral pancreatitis and pancreatic cancer[J].BMC Gastroenterol,2013,13:2.
[11]KONGKAM P,LAKANANURAK N,NAVICHARERN P,et al.Combination of EUS-FNA and elastography(strain ratio)to exclude malignant solid pancreatic lesions:A prospective single-blinded study[J].J Gastroenterol Hepatol,2015,30(11):1683-1689.
[12]CARRARA S,DI L M,GRIZZI F,et al.EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions[J].Gastrointest Endosc,2018,87(6):1464-1473.
[13]OKASHA H,ELKHOLY S,EL-SAYED R,et al.Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions[J].World J Gastroenterol,2017,23(32):5962-5968.
[14]LUZ L P,AL-HADDAD M A,SEY M S,et al.Applications of endoscopic ultrasound in pancreatic cancer[J].World JGastroenterol,2014,20(24):7808-7818.
[15]LEE T Y,CHEON Y K,SHIM C S.Clinical role of contrast-enhanced harmonic endoscopic ultrasound in differentiating solid lesions of the pancreas:a single-center experience in Korea[J].Gut Liver,2013,7(5):599-604.
[16]LI X Z,SONG J,SUN Z X,et al.Diagnostic performance of contrast-enhanced ultrasound for pancreatic neoplasms:a systematic review and meta-analysis[J].Dig Liver Dis,2018,50(2):132-138.
[17]YAMASHITA Y,KATO J,UEDA K,et al.Contrast-enhanced endoscopic ultrasonography for pancreatic tumors[J].Biomed Res Int,2015,2015:491782.
[18]ZHANG S,DEFRIAS D V,ALASADI R,et al.Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA):experience of an academic centre in the USA[J].Cytopathology,2010,21(1):35-43.
[19]PARK J K,LEE Y J,LEE J K,et al.KRAS mutation analysis of washing fluid from endoscopic ultrasound-guided fine needle aspiration improves cytologic diagnosis of pancreatic ductal adenocarcinoma[J].Oncotarget,2017,8(2):3519-3527.
[20]KONGKAM P,ANG T L,VU C K,et al.Current status on the diagnosis and evaluation of pancreatic tumor in Asia with particular emphasis on the role of endoscopic ultrasound[J].J Gastroenterol Hepatol,2013,28(6):924-930.
[21]KAMATA K,KITANO M,OMOTO S,et al.New endoscopic ultrasonography techniques for pancreaticobiliary diseases[J].Ultrasonography,2016,35(3):169-179.
[22]SHI S,LIANG C,XU J,et al.The strain ratio as obtained by endoscopic ultrasonography elastography correlates with the stroma proportion and the prognosis of local pancreatic cancer[J].Ann Surg,2018.[Epub ahead of print]
[23]TIRIAC H,BUCOBO J C,TZIMAS D,et al.Successful creation of pancreatic cancer organoids by means of EUS-guided fine-needle biopsy sampling for personalized cancer treatment[J].Gastrointest Endosc,2018,87(6):1474-1480.
[24]MINAGA K,TAKENAKA M,KAMATA K,et al.Alleviating pancreatic cancer-associated pain using endoscopic ultrasound-guided neurolysis[J].Cancers(Basel),2018,10(2):E50.
[25]LEVY M J,ALBERTS S R,BAMLET W R,et al.EUS-guided fine-needle injection of gemcitabine for locally advanced and metastatic pancreatic cancer[J].Gastrointest Endosc,2017,86(1):161-169.
[26]HOLT B A,HAWES R,HASAN M,et al.Biliary drainage:role of EUS guidance[J].Gastrointest Endosc,2016,83(1):160-165.
[27]BANG J Y,NAVANEETHAN U,HASAN M,et al.Stent placement by EUS or ERCP for primary biliary decompression in pancreatic cancer:a randomized trial (with videos)[J].Gastrointest Endosc,2018,88(1):9-17.
[28]SCOPELLITI F,PEA A,CONIGLIARO R,et al.Technique,safety,and feasibility of EUS-guided radiofrequency ablation in unresectable pancreatic cancer[J].Surg Endosc,2018.[Epub ahead of print]
[29]JAVED S,BHUTANI M S.Endoscopic ultrasound-guided radiation therapy in pancreatic cancer[J].Minerva Gastroenterol Dietol,2013,59(4):377-386.
[30]DEWITT J M,SANDRASEGARAN K,O’NEIL B,et al.Phase1 study of EUS-guided photodynamic therapy for locally advanced pancreatic cancer[J].Gastrointest Endosc,2018.[Epub ahead of print]
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