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首页> 美国卫生研究院文献>Gastroenterology Research and Practice >Pancreatic Cysts: Diagnostic Role of EUS-Guided Microforceps Biopsy and Confocal Laser Endomicroscopy
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Pancreatic Cysts: Diagnostic Role of EUS-Guided Microforceps Biopsy and Confocal Laser Endomicroscopy

机译：胰腺囊肿：超声内镜引导下的微钳活检和共聚焦激光内镜检查的诊断作用

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Frequent use of high-quality cross-sectional imaging has led to a significant rise in diagnosis of pancreatic cystic lesions (PCLs). Despite the fact that enormous effort has been put into the research of PCLs within the last two decades and multiple guidelines have been developed, our clinical decision-making especially in regard to mucinous lesions remains limited. Currently, clinical assessment, cross-sectional imaging and EUS with fluid analysis (if appropriate) belong to the standard care in patients with PCLs. For differentiation of mucinous from nonmucinous cysts, the sensitivity of cytological investigation and CEA in the cyst fluid is 42% and 52-79%, respectively. Due to the limited accuracy, further diagnostic tools are warranted. Two EUS-guided approaches have been introduced recently. Through-the-(19-gauge EUS) needle Moray microforceps have been developed, and several studies have acknowledged their contribution to the correct diagnosis as they help to overcome limited cellularity of the EUS-guided cyst fluid aspiration and traditional cytology. Confocal laser endomicroscopy offers real-time images and seems to be a promising method for the diagnosis and differential diagnosis of pancreatic PCLs. Example images of the needle-based confocal laser endomicroscopy criteria for the diagnosis of PCLs have been suggested recently. Before both, Moray microforceps and confocal laser endomicroscopy can be widely accepted, further studies are necessary to determine the real diagnostic yield and the clinical efficacy.
机译：频繁使用高质量的断层成像已导致胰腺囊性病变（PCL）的诊断显着增加。尽管在过去的二十年中已经为PCL的研究付出了巨大的努力，并且已经制定了多个指南，但我们的临床决策，尤其是关于粘液性病变的临床决策仍然有限。当前，临床评估，横断面成像和带液体分析的EUS（如果适用）属于PCL患者的标准护理。为了区分粘液性囊肿和非粘液性囊肿，囊肿液中细胞学检查和CEA的敏感性分别为42％和52-79％。由于准确性有限，因此需要进一步的诊断工具。最近引入了两种EUS指导的方法。已经开发出了穿过（19口径EUS）针头的Moray微型镊子，并且一些研究已经承认它们对正确诊断的贡献，因为它们有助于克服EUS引导的囊肿液抽吸和传统细胞学的局限性。共聚焦激光内窥镜检查可提供实时图像，似乎是诊断和鉴别胰腺PCL的有前途的方法。最近已经提出了用于诊断PCL的基于针的共聚焦激光内窥镜检查标准的示例图像。在这两者之前，Moray显微钳和共聚焦激光内窥镜检查都可以被广泛接受，需要进一步的研究来确定真正的诊断率和临床疗效。

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