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Korean J Pancreas Biliary Tract > Volume 3(1): > Article
췌장의 악성 및 염증성 종양의 감별진단에서의 내시경 초음파의 역할
노임환1, 진영주1, 임창영1, 송일환1, 김정원1, 김정택2
1단국대학교 의과대학 내과학교실
2단국대학교 의과대학 외과학교실, 소화기 연구소
The Role of Endoscopic Ultrasonography(EUS) in Differencial Diagnosis between Pancreatic Cancer and Inflammatory Mass of Pancreas
Im Hwan Roe1, Young Joo Chin1, Chang Young Lim1, Il Han Song1, Jung Won Kim1, Jung Taik Kim2
1Department of Internal Medicine, Dankook University College of Medicine, Chunan, South Korea
2Department of Surgery, Research Institute for Gastroenterology, Dankook University College of Medicine, Chunan, South Korea
Corresponding Author: Im Hwan Roe ,
ABSTRACT
Background/Aims:
The differential diagnosis between the pancreatic cancer and inflamrnatory mass of pancreas is important to decide the operability and extent of surgery, and is diffcult in some cases in spite of the combination of the results of US, CT, and ERCP. We studied the diagnostic accuracy and role of EUS in differential diagnosis between the cancer and inflammatory mass.
Methods:
Thirty cases of pancreatic adenocarcinoma(M:F= 17:13, 63.9±9.4 yrs) and 14 cases of inflammatory mass(histologic diagnosis 4 cases, follow-up diagnosis 10 cases, M:F=12:2, 52.6±13.8 yrs) were examined with US, CT, ERCP, and with EUS.
Results:
The diagnostic accuracy of US, CT, ERCP, and EUS is 41.6%, 83.3%, 83.3%(including rate of inaccessible cases of luminal stenpsis due to tumor invasion), and 91.6% respectively in pancreatic cancer, and 25.0%, 33.3%, 75.0% and 83.3%, respectively in pancreatic inflammatory mass. Echo findings for the differential diagnosis were 95.8%, 83.3% in pancreatic cancer and inflammatory mass, respectively for internal hypoechoicity of the tumor, 91.7%, 66.7% for heterogeneity of the tumor(p<0.05), 83.3%, 33.3% for irregularity of the peripheral echo(p<0.05), 8.3%, 66.7% for small bright foci within the tumor(p<0.05), 75.0%, 41.7% for clear boundary tumor echo (p<0.05). And also EUS findings were 58.3%, 0% for vascular invasion, 25.0%, 16.7% for lymph node enlargement, 4.2%, 0% for ascites in cancer and inflamrnation, respectively.
Conclusions:
In conclusion, the EUS gives more distinct pancreatic tumor images compared with US or CT, and the accuracy of EUS is superior to the US, CT, and ERCP (including endoscopic access failure cases). And also EUS is considered to be a useful method to diffrenciate the cancer from the inflammatory mass.
Keywords: Endoscopic ultrasonography(EUS), Pancreatic cancer, Inflammatory mass of pancreas, Differential diagnosis
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