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胰腺囊性肿瘤:超声内镜的诊治研究进展
王心悦,孙力祺,黄浩杰,金震东*
0
(海军军医大学(第二军医大学)第一附属医院消化内科, 上海 200433
*通信作者)
摘要:
胰腺囊性肿瘤(PCN)是一类具有显著异质性的胰腺肿瘤,近年来其检出率不断增加,逐渐成为临床医师关注的问题。超声内镜(EUS)可以贴近胰腺扫查并进行穿刺活检,对于PCN的诊断和治疗具有一定的优势。本文主要总结了EUS应用于PCN诊断和治疗的最新进展。囊液分子标志物(如Kirsten大鼠肉瘤病毒癌基因同源物、GNAS复合体基因座、冯·希佩尔-林道肿瘤抑制基因)及新兴内镜技术(如EUS引导下细针型共聚焦显微内镜和经穿刺针囊内活检术)都被证明可提高PCN的诊断准确性。EUS引导下消融术是新兴的PCN微创治疗技术,特别是化学消融的有效性和安全性得到大量研究的支持。
关键词:  胰腺囊性肿瘤  黏液性肿瘤  非黏液性肿瘤  超声内镜  消融术
DOI:10.16781/j.CN31-2187/R.20230765
投稿时间:2023-12-26修订日期:2024-02-27
基金项目:国家自然科学基金(8217032680).
Pancreatic cystic neoplasms: research progress in diagnosis and treatment of endoscopic ultrasound
WANG Xinyue,SUN Liqi,HUANG Haojie,JIN Zhendong*
(Department of Gastroenterology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Pancreatic cystic neoplasm (PCN) is a category of pancreatic tumors with significant heterogeneity. In recent years, the detection rate of PCN has been increasing, and it has gradually become a concern of clinicians. Endoscopic ultrasound (EUS) can be close to the pancreas for scanning and biopsy, and it has certain advantages in the diagnosis and treatment of PCN. This review mainly summarizes the latest progress of EUS in the diagnosis and treatment of PCN. Cyst fluid molecular markers, such as Kirsten rat sarcoma viral oncogene homolog, GNAS complex locus, Von Hippel-Lindau tumor suppressor gene, as well as emerging endoscopic technologies such as EUS-guided needle based confocal laser endomicroscopy and through-the-needle biopsy, have all showed the potential to significantly improve the diagnostic accuracy of PCN. EUS-guided ablation is an emerging minimally invasive treatment technique for PCN, with the efficacy and safety of chemical ablation being supported by a substantial amount of research.
Key words:  pancreatic cystic neoplasms  mucinous neoplasms  non-mucinous neoplasms  endoscopic ultrasound  ablation