检索结果-南通市图书馆

Utility of endoscopic ultrasound, cytology and fluid carcinoembryonic antigen and CA 19-9 levels in pancreatic cystic lesions

引用

World Journal of Gastroenterology 2007年第29期13卷 3962-3966页

作者： Abdulrahman M Aljebreen Joseph Romagnuolo Rafael Perini Francis Sutherland Division of Gastroenterology Department of Medicine King Saud University Riyadh Saudi Arabia Medical University of South Carolina Digestive Disease Center Charleston South Carolina United States Division of Gastroenterology University of Calgary Calgary Alberta Canada Department of General Surgery University of Calgary Calgary Alberta Canada

AIM: To assess the diagnostic accuracy of endoscopic ultrasound (EUS), fluid tumor markers and cytology in distinguishing benign from (pre)malignant pancreatic cystic lesions. METHODS: 46 consecutive patients, referred to a gastroenterologist and surgeon for a symptomatic or incidental pancreatic cyst, were reviewed. EUS, cytology, and carcinoembryonic antigen (CEA) and carbohydrate antigen (CA 19-9) levels were compared with the final diagnosis, based on surgical pathology and/or imaging follow-up of at least 12 mo. Cysts were classified as benign (pseudocyst, serous cystadenoma) or malignant/ pre-malignant (mucinous cystic neoplasm). Receiver- operator characteristics (ROC) curve analysis was performed. RESULTS: The mean age was 56 years; 29% were male and median cyst diameter was 3 cm. Final outcome was obtained in 41 (89%) patients. Twenty-three (56%) of these 41 had surgical pathology. Twenty-three (56%) had benign lesions and 18 (44%) had malignant/pre- malignant lesions. Sensitivity, specificity and positive and negative predictive value of EUS alone to distinguish benign from malignant/premalignant pancreatic cystic lesions were 50%, 56%, 36% and 54% and for cytology were 71%, 96%, 92% and 85%, respectively. The corresponding values for the ROC-derived ideal cutoffswere 75%, 90%, 75%, 90% for CA 19-9 (> 37 U/mL) and 70%, 85%, 79% and 78% for CEA (> 3.1 ng/mL). Subgroup analysis of those with surgical pathology yielded almost identical performance and cutoffs. CONCLUSION: Cytology and cyst fluid tumor marker analysis is a very useful tool in distinguishing benign from (pre)malignant pancreatic cystic lesions.

关键词： Endoscopic ultrasound Carcinoembryonic antigen CA 19-9 pancreatic cystic lesions Fine needle aspiration

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

The Hong Kong consensus recommendations on the diagnosis and management of pancreatic cystic lesions

引用

Hepatobiliary Surgery and Nutrition 2023年第5期12卷 715-735,I0019-I0020页

作者： Tan-To Cheung Yuk Tong Lee Raymond Shing-Yan Tang Wong Hoi She Kai Chi Cheng Chin Cheung Cheung Keith Wan Hang Chiu Kenneth Siu Ho Chok Wing Sun Chow Tak Wing Lai Wai-Kay Seto Thomas Yau Department of Surgery Queen Mary HospitalThe University of Hong KongHong KongChina Gastroenterologist in private practice Hong KongChina Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina Department of Surgery Kwong Wah HospitalHong KongChina Department of Surgery Tuen Mun HospitalHong KongChina Department of Radiology&Imaging Queen Elizabeth HospitalHong KongChina Department of Medicine The University of Hong KongHong KongChina Department of Surgery Princess Margaret HospitalHong KongChina Department of Medicine School of Clinical MedicineThe University of Hong KongHong KongChina State Key Laboratory of Liver Research The University of Hong KongHong KongChina

Background:The finding of pancreatic cystic lesions(PCL)on incidental imaging is becoming increasingly *** studies report a prevalence of 2.2-44.7%depending on the population,imaging modality and indication for imaging,and the prevalence increases with *** with PCL are at risk of developing pancreatic cancer,a disease with a poor *** publication summarizes recommendations for the diagnosis and management of PCL and post-operative pancreatic exocrine insufficiency(PEI)from a group of local ***:Clinical evidence was consolidated from narrative reviews and consensus statements formulated during two online meetings in March *** expert panel included gastroenterologists,hepatobiliary surgeons,oncologists,radiologists,and ***:Patients with PCL require careful investigation and follow-up due to the risk of malignant transformation of these *** should undergo clinical investigation and pancreas-specific imaging to classify lesions and understand the risk profile of the *** indicated,patients should undergo pancreatectomy to excise *** pancreatectomy,patients are at risk of PEI,leading to gastrointestinal dysfunction and ***,such patients should be monitored for symptoms of PEI,and promptly treated with pancreatic enzyme replacement therapy(PERT).Patients with poor response to PERT may require increases in dose,addition of a proton pump inhibitor,and/or further investigation,including tests for pancreatic *** are also at risk of new-onset diabetes mellitus after pancreatectomy;they should be screened and treated with insulin if ***:These statements are an accurate summary of our approach to the diagnosis and management of patients with PCL and will be of assistance to clinicians treating these patients in a similar clinical landscape.

关键词： pancreatic cystic lesions pancreatic endocrine insufficiency pancreatic enzyme replacement therapy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Machine learning in endoscopic ultrasonography and the pancreas:The new frontier?

引用

Artificial Intelligence in Gastroenterology 2022年第2期3卷 54-65页

作者： Cem Simsek Linda S Lee Department of Gastroenterology Hepatology and EndoscopyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMA 02215United States Division of Gastroenterology Hepatology and EndoscopyDepartment of MedicineBrigham and Women's HospitalHarvard Medical SchoolBostonMA 02115United States

pancreatic diseases have a substantial burden on society which is predicted to increase further over the next *** ultrasonography(EUS)remains the best available diagnostic method to assess the pancreas,however,there remains room for *** intelligence(AI)approaches have been adopted to assess pancreatic diseases for over a decade,but this methodology has recently reached a new era with the innovative machine learning algorithms which can process,recognize,and label endosonographic *** review provides a targeted summary of AI in EUS for pancreatic *** studies cover a wide spectrum of pancreatic diseases from pancreatic cystic lesions to pancreatic masses and diagnosis of pancreatic cancer,chronic pancreatitis,and autoimmune *** these,AI models seemed highly successful,although the results should be evaluated carefully as the tasks,datasets and models were greatly *** addition to use in diagnostics,AI was also tested as a procedural real-time assistant for EUS-guided biopsy as well as recognition of standard pancreatic stations and labeling anatomical landmarks during routine *** thus far have suggested that the adoption of AI in pancreatic EUS is highly promising and further opportunities should be explored in the field.

关键词： Artificial intelligence Pancreas Endoscopic ultrasonography pancreatic cancer Autoimmune pancreatitis pancreatic cystic lesions

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

胰腺导管内乳头状粘液瘤恶变的相关预测因素分析

胰腺导管内乳头状粘液瘤恶变的相关预测因素分析

引用

作者： Harsha Ajoodhea 浙江大学

学位级别：硕士

目的：筛选胰腺导管内乳头状粘液瘤发生恶变的相关预测因素。方法：回顾性分析在邵逸夫医院自2002年到2014年所有诊断为胰腺导管内乳头状粘液瘤患者的资料。根据文献及临床经验,设立26个相关因素,通过单因素分析、Logist回归分析及ROC分... 详细信息

目的：筛选胰腺导管内乳头状粘液瘤发生恶变的相关预测因素。方法：回顾性分析在邵逸夫医院自2002年到2014年所有诊断为胰腺导管内乳头状粘液瘤患者的资料。根据文献及临床经验,设立26个相关因素,通过单因素分析、Logist回归分析及ROC分析,筛选术前可以预测胰腺导管内乳头状粘液瘤恶变的相关因素。结果：术前AST (P<0.004)和ALT (P<0.002)水平,主胰管直径≥5mm(P<0.002),囊肿≥3cm(P<0.033),CT增强的固体成分(P<0.026)和主胰管直径突然变化与远端胰腺萎缩(P<0.015)与胰腺导管内乳头状粘液瘤恶变有相关性。饮酒量(P<0.046),术前AST (P<0.031)和ALT (P<0.043)水平,主胰管直径≥5mm(P<0.015),囊肿大小≥3cm(P<0.019),增强的固体成分(P<0.033),主胰管直径突然变化与远端胰腺萎缩(P<0.046)和胰腺导管内乳头状粘液瘤具有侵袭性有相关性。主胰管直径可能是预测胰腺导管内乳头状粘液瘤恶变和侵袭的关键因素[0.791(P<0.002,95%CI:0.668-0.913) and0.772(P<0.010,95%CI:0.635-0.909).结论：囊肿≥3cm,主胰管≥5mm,增强的固体成分,主胰管突然变化与远端胰腺萎缩以及术前ALT和AST水平与胰腺导管内乳头状粘液瘤恶变相关,其中主胰管直径是最重要的因素。饮酒史与胰腺导管内乳头状粘液瘤侵袭性相关。

关键词： Intraductal papillary Mucinous Neoplasm pancreatic cystic lesions Malignancy Invasive Carcinoma Alcohol

来源：

同方学位论文库评论

在线全文

同方学位论文库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：