mossjМосковский хирургический журналMoscow Surgical Journal2072-3180ООО «ПРОФИЛЬ – 2С»10.17238/issn2072-3180.2018.1.10-14mossj-51Research ArticleСтатьиСРАВНИТЕЛЬНАЯ ОЦЕНКА ТОНКОИГОЛЬНОЙ АСПИРАЦИОННОЙ БИОПСИИ ПОД КОНТРОЛЕМ ЭНДОСКОПИЧЕСКОЙ УЛЬТРАСОНОГРАФИИ ПРИ ЗАБОЛЕВАНИЯХ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫCOMPARATIVE EVALUATION OF EUS-GUIDED FINE NEEDLE ASPIRATION AT PANCREATIC DISEASESДвойниковаЕ. Р.DvoynikovaE. R.katerinkadw@gmail.comСтегнийК. В.StegniyK. V.kstegniy@gmail.comГончарукР. А.GoncharukR. A.rgoncharuk@rambler.ruАгаповМ. Ю.AgapovM. YU.misha_agapov@mail.ruТихоокеанский государственный медицинский университет Минздрава РФРоссияPacific State Medical UniversityRussian FederationОтделенческая клиническая больница на ст. Владивосток ОАО «РЖД»РоссияJSC Russian Railways hospital branch at the Vladivostok stationRussian Federation201831072020011014Copyright © Двойникова Е.Р., Стегний К.В., Гончарук Р.А., Агапов М.Ю., 20202020Двойникова Е.Р., Стегний К.В., Гончарук Р.А., Агапов М.Ю.Dvoynikova E.R., Stegniy K.V., Goncharuk R.A., Agapov M.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.mossj.ru/jour/article/view/51

Наиболее часто рак поджелудочной железы диагностируется на поздних стадиях, средний показатель выявления на III и IV стадиях в России - 59,5% [1]. Уровень пациентов с морфологически верифицированным диагнозом постепенно возрастает, доля больных, с выполнен- ной верификацией диагноза, составляет в России 61,2 %, в Приморском крае - 20,6 % [1]. Ретроспективно оценены результаты УЗИ, КТ, ЭУС и тонкоигольной аспирационной биопсии под контролем эндосонографии у пациентов с очаговыми образованиями поджелудочной железы на базе эндоскопического отделения Медицинского центра ФГАОУ ВО «ДВФУ» с марта 2015 по май 2017 г. При сравнении трех групп с «золотым» стандартом - с гистологическим исследованием, при выполнении оперативного вмешательства, или результатами катамнеза, - доверительный интервал с точностью вычисления более 95% для частоты постановки правильного диагноза в группе 1 составила от 80,31% до 98,41%, в группе 2 - от 92,29% до 100%, в группе 3 - 100%. Тонкоигольная аспирационная биопсия позволяет получить достаточный материал для морфологиче- ской верификации процесса поджелудочной железы, однако, необходимо осуществлять выбор диаметра иглы.

Background: Most often pancreatic cancer is diagnosed at later stages, the average detection rate at stages III and IV in Russia is 59.5% [1]. The “gold” stan- dard for the verification of pathological processes is histological examination, but, in connection with the localization of the pancreas, obtaining tissue with the least amount of complications is difficult.Methods: It was evaluated the results of eUS - guided fine needle aspiration at pancreatic diseases with examination on the material of 124 clinical observa- tions.Results: When comparing the three different diameter needle for eUS - guided fine needle aspiration with the “gold” standard: with a histological examina- tion based on the results of surgical intervention, or with the data of a catamnesis, the accuracy of setting the correct diagnosis in the group of fine needle aspiration biopsy with 19G needle (group 1) was within the confidence interval from 80.31% to 98.41 %, in group 2 - from 92.29% to 100%, in group 3 - 100%. In 46 cases (36.5%) revealed malignant neoplasms of the pancreas, 22 persons (17.5%) with pseudocysts of the pancreas, and 18 (14.3%) patients with inflammatory pseudotumor of the pancreas.Conclusions: eUS - guided fine-needle aspiration biopsy of the pancreas with different diameter needle allow verifying the pathological process of the pancreas.

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The authors declare that there are no conflicts of interest present.