摘要目的 探讨超声引导经皮粗针穿刺活检(percutaneous ultrasound‐guided core needle biopsy , PUS‐CNB)与超声内镜引导下细针穿刺(endoscopic ultrasound‐guided fine needle aspiration , EUS‐FNA)在胰腺占位性病变诊断中的安全性及临床价值.方法 选取109例临床难以确诊的胰腺占位病变,超声引导下避开大血管进针并对病灶内高度可疑处进行取材,其中单独行 PUS‐CNB者82例,单独行EUS‐FNA者19例,两者均行者8例.术前记录病灶部位、大小等,所取标本有明确病理诊断者为取材满意,穿刺过程中因存在高风险因素最终无法穿刺为取材不成功,穿刺术后随访并记录并发症.结果 PUS‐CNB取材满意率和取材成功率分别为 98 .89% 和100%,诊断准确率和假阴性率分别为97 .78% 和2 .22%; EUS‐FNA取材满意率和取材成功率分别为 96 .15% 和 96 .30%,诊断准确率和假阴性率分别为80 .77% 和23 .81%.两者穿刺术后均未出现严重的胰瘘、出血、针道处种植转移等并发症.结论 PUS‐CNB和EUS‐FNA均是安全有效的诊断胰腺良恶性占位性病变的方法,具有较高的临床价值.合理选择应用EUS‐FNA和PUS‐CNB ,可安全可靠地鉴别诊断胰腺良恶性病变.

abstractsObjective To explore the safety and clinical value of percutaneous ultrasound‐guided core needle biopsy( PUS‐CNB) and endoscopic ultrasound‐guided fine needle aspiration( EUS‐FNA ) in pancreas mass . Methods Ultrasound‐guided biopsy were performed in 109 cases who were difficult to diagnose to get specimens from the highly suspicious parts of the lesions by avoiding vessels . PUS‐CNB were performed in 82 cases , EUS‐FNA in 19 cases and both in 8 cases . T he site and size of lesions were recorded preopeartion . Specimens with clear pathological diagnosis were considered as satisfactory materials . Specimens that were impossible to puncture due to the existence of high risk factors in the process of puncture were considered as unsuccessful biopsy . All patients were followed up after biopsy and complications were recorded . Results The satisfaction rate and success rate of PUS‐CNB were 98 .89% and 100% ,the diagnostic accuracy and false negative rate were 97 .78% and 2 .22% . T he satisfaction rate and success rate of EUS‐FNA were 96 .15% and 96 .30% ,the diagnostic accuracy and false negative rate were 80 .77% and 23 .81% . T here were no serious complications such as pancreatic fistula ,hemorrhage and needle transfer at the needle site after puncture . Conclusions Both PUS‐CNB and EUS‐FNA are safe and effective methods for the diagnosis of benign and malignant pancreatic lesions and have high clinical values . Reasonable selection of EUS‐FNA and PUS‐CNB can safely and reliably identify and diffentiate the benign and malignant pancreatic lesions .