Diagnostic value of endoscopic ultrasonography for duodenal papillary carcinoma and analysis on influencing factors

Jia YANG; Ziyi WANG; Lei CHEN; Yao ZHANG; Jing CHEN; Liping GAO; Xiaofeng FENG

doi:10.16016/j.2097-0927.202312048

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Diagnostic value of endoscopic ultrasonography for duodenal papillary carcinoma and analysis on influencing factors

Clinical Medicine | 更新时间：2026-01-09

- Diagnostic value of endoscopic ultrasonography for duodenal papillary carcinoma and analysis on influencing factors
- Journal of Army Medical University Vol. 46, Issue 22, Pages: 2561-2568(2024)
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)第一附属医院消化内科
  2.400038 重庆，陆军军医大学(第三军医大学)军事预防医学系军队流行病学教研室
  3.400038 重庆，陆军军医大学(第三军医大学)第一附属医院整形外科
- 作者简介：
- 基金信息：
  
  the Appropriate Health Technology Promotion Project of Chongqing Health Commission(2023jstg005)
- DOI：10.16016/j.2097-0927.202312048
  CLC： R181.32;R730.41;R735.31
- Received：08 December 2023，
  
  Revised：2024-09-06，
  
  Published：30 November 2024
- 稿件说明：
移动端阅览
Jia YANG, Ziyi WANG, Lei CHEN, et al. Diagnostic value of endoscopic ultrasonography for duodenal papillary carcinoma and analysis on influencing factors[J]. Journal of Army Medical University, 2024, 46(22): 2561-2568.
DOI：

Jia YANG, Ziyi WANG, Lei CHEN, et al. Diagnostic value of endoscopic ultrasonography for duodenal papillary carcinoma and analysis on influencing factors[J]. Journal of Army Medical University, 2024, 46(22): 2561-2568. DOI： 10.16016/j.2097-0927.202312048.

摘要

目的

评估内镜超声检查(endoscopic ultrasonography，EUS)在十二指肠乳头癌术前分期和导管扩张中的诊断价值，分析其诊断准确度的影响因素。

方法

采用横断面研究设计，收集2018年1月至2023年8月于本院消化内科就诊且经病理诊断为十二指肠乳头癌并接受EUS的患者，采用灵敏度、特异度、阳性预测值、阴性预测值和准确度评价EUS对十二指肠乳头癌术前分期的诊断价值。单因素和多因素分析确定影响EUS诊断准确度的因素。

结果

本研究共纳入102例经病理诊断确诊为十二指肠乳头癌的患者，其中男性59例，女性43例。患者平均年龄为62岁。患者确诊前均接受EUS，EUS对肿瘤T分期的准确度为86.27%，对T1、T2、T3、T4病变的灵敏度和特异度分别是84.21%、92.31%、85.00%、60.00%和95.31%、88.89%、96.34%、98.97%。T1、T2、T3、T4病变T分期的阳性预测值分别为91.43%、83.72%、85.00%、75.00%，阴性预测值分别为91.04%、94.92%、96.34%、97.96%。有14例患者的T分期被EUS错误分期。EUS评估导管内扩张的准确度为75.49%，对导管扩张的敏感性、特异性、阳性预测值和阴性预测值分别为96.97%、66.67%、98.97%、40.00%。EUS对胰管扩张诊断准确度的独立预测因素为神经浸润、肿瘤大小和T分期；而对胆管扩张诊断准确度的独立危险因素为神经浸润和碱性磷酸酶。

结论

EUS对十二指肠乳头癌术前分期诊断价值高，神经浸润、肿瘤大小、T分期、碱性磷酸酶可能是其诊断准确度的影响因素。

Abstract

Objective

To evaluate the diagnostic value of endoscopic ultrasonography (EUS) in the preoperative staging and ductal dilatation of duodenal papillary carcinoma and analyze the factors influencing its diagnostic accuracy.

Methods

A cross-sectional trial was conducted on the patients with pathologically-diagnosed duodenal papillary carcinoma and undergoing EUS in the First Affiliated Hospital of Army Medical University from January 2018 to August 2023. The diagnostic value of EUS for the preoperative staging of duodenal papillary carcinoma was evaluated using sensitivity

specificity

positive predictive value

negative predictive value

and accuracy. Univariate and multivariate analyses were performed to determine the factors affecting the diagnostic accuracy of EUS.

Results

A total of 102 patients with duodenal papillary carcinoma were included

including 59 males and 43 females

at a mean age of 62 years

and all of them underwent EUS before diagnosis. The accuracy of EUS for tumor T-staging was 86.27%

the sensitivity and specificity for T1

and T4 lesions were 84.21%

92.31%

85.00%

60.00%

and 95.31%

88.89%

96.34%

and 98.97%

respectively. The positive predictive value for T-staging of T1

and T4 lesions was 91.43%

83.72%

85.00%

and 75.00%

and the negative predictive values were 91.04%

94.92%

96.34%

and 97.96%

respectively. There were 14 patients whose T-staging was incorrectly staged by EUS. The accuracy of EUS in assessing intraductal dilatation was 75.49%

and the sensitivity

specificity

positive predictive value

and negative predictive value for ductal dilatation were 96.97%

66.67%

98.97%

and 40.00%

respectively. In addition

the independent predictors of diagnostic accuracy of EUS for pancreatic duct dilatation were nerve infiltration

tumor size

and T stage; whereas the independent risk factors for diagnostic accuracy of bile duct dilatation were nerve infiltration and alkaline phosphatase.

Conclusion

EUS has quite higher diagnostic value for preoperative staging of duodenal papillary carcinoma

and nerve infiltration

tumor size

T stage

T stage and alkaline phosphatase may be the influencing factors for its diagnostic accuracy.

关键词

Keywords

references

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