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Pankreas Lezyonlarında Ultrasonografi Eşliğinde Perkütan Kor İğne Biyopsilerinin Tanısal Doğruluğu

Year 2025, Volume: 2 Issue: 2, 100 - 108, 30.06.2025
https://doi.org/10.70058/cjm.1599462

Abstract

Amaç
Bu çalışmada, üniversite hastanemizde pankreasın solid kitlelerine yönelik ultrason eşliğinde yapılan perkütan kor iğne biyopsilerinin sonuçları ve komplikasyonları değerlendirilmiştir.
Yöntemler
Ocak 2009 ve Haziran 2013 tarihleri arasında 53 hastaya (30 erkek, 23 kadın), toplam 60 biyopsi işlemi uygulanmış ve histopatolojik sonuçlara göre 11 örnek benign, 45 örnek malign olarak değerlendirilmiştir.
Bulgular
Duyarlılık %84,9, özgüllük %100 ve tanısal doğruluk %85,7 olarak sonuçlanmıştır. Biyopsi işlemleri sırasında veya sonrasında herhangi bir komplikasyon gözlenmemiştir
Sonuç
Bu çalışma, ultrason eşliğinde biyopsinin çok düşük komplikasyon oranı, yüksek tanısal doğruluğu ve duyarlılığı ile güvenilir, zaman ve maliyet tasarrufu sağlayan bir yöntem olduğunu, ancak benign biyopsi bulgularının pankreatik malignite varlığını dışlamak için kullanılmaması gerektiğini ve yüksek klinik malignite şüphesi varsa biyopsinin tekrarlanması gerektiğini göstermektedir.

References

  • Tuncer, M. Kanserin ülkemiz ve dünyadaki önemi, hastalık yükü ve kanser kontrol politikaları. Türkiye’de Kanser Kontrolü, Sağlık Bakanlığı Yayınları. 2009. 707, 5-9.
  • Schneider G, Schmid RM. Genetic alterations in pancreatic carcinoma. Mol Cancer. 2003;2:15. Published 2003 Jan 22. doi:10.1186/1476-4598-2-15
  • TC. Sağlık Bakanlığı 2003 yılı Kanser İstatistikleri. Avaible at: http://www.saglik.gov.tr/extras/istatistikler/apk2003/098.htm -99.htm.
  • Rumack, M.C., Wilson, R.S., Charboneau, J.W., 2011. Diagnostic Ultrasound. 4th edition. Mosby. Philadelphia.
  • American Cancer Society. Cancer facts & figures 2013. Society, A. C. Atlanta, pp. 25.
  • Parker SH, Jobe WE, Dennis MA, et al. US-guided automated large-core breast biopsy. Radiology. 1993;187(2):507-511. doi:10.1148/radiology.187.2.8475299
  • Karlson BM, Forsman CA, Wilander E, et al. Efficiency of percutaneous core biopsy in pancreatic tumor diagnosis. Surgery. 1996;120(1):75-79. doi:10.1016/s0039-6060(96)80244-3
  • Matsubara J, Okusaka T, Morizane C, Ikeda M, Ueno H. Ultrasound-guided percutaneous pancreatic tumor biopsy in pancreatic cancer: a comparison with metastatic liver tumor biopsy, including sensitivity, specificity, and complications. J Gastroenterol. 2008;43(3):225-232. doi:10.1007/s00535-007-2142-9
  • Moossa AR, Altorki N. Pancreatic biopsy. Surg Clin North Am. 1983;63(6):1205-1214. doi:10.1016/s0039-6109(16)43183-x
  • Ingram DM, Sheiner HJ, Shilkin KB. Operative biopsy of the pancreas using the Trucut needle. Aust N Z J Surg. 1978;48(2):203-206. doi:10.1111/j.1445-2197.1978.tb07307.x
  • Turner BG, Cizginer S, Agarwal D, Yang J, Pitman MB, Brugge WR. Diagnosis of pancreatic neoplasia with EUS and FNA: a report of accuracy. Gastrointest Endosc. 2010;71(1):91-98. doi:10.1016/j.gie.2009.06.017
  • Elvin A, Andersson T, Scheibenpflug L, Lindgren PG. Biopsy of the pancreas with a biopsy gun. Radiology. 1990;176(3):677-679. doi:10.1148/radiology.176.3.2167498
  • Paulsen SD, Nghiem HV, Negussie E, Higgins EJ, Caoili EM, Francis IR. Evaluation of imaging-guided core biopsy of pancreatic masses. AJR Am J Roentgenol. 2006;187(3):769-772. doi:10.2214/AJR.05.0366
  • Di Stasi M, Lencioni R, Solmi L, et al. Ultrasound-guided fine needle biopsy of pancreatic masses: results of a multicenter study. Am J Gastroenterol. 1998;93(8):1329-1333. doi:10.1111/j.1572-0241.1998.443_m.x
  • Gress F, Michael H, Gelrud D, et al. EUS-guided fine-needle aspiration of the pancreas: evaluation of pancreatitis as a complication. Gastrointest Endosc. 2002;56(6):864-867. doi:10.1067/mge.2002.129602
  • Smith EH. Complications of percutaneous abdominal fine-needle biopsy. Review. Radiology. 1991;178(1):253-258. doi:10.1148/radiology.178.1.1984314
  • Johnson DE, Pendurthi TK, Balshem AM, et al. Implications of fine-needle aspiration in patients with resectable pancreatic cancer. Am Surg. 1997;63(8):675-680.
  • Hartwig W, Schneider L, Diener MK, Bergmann F, Büchler MW, Werner J. Preoperative tissue diagnosis for tumours of the pancreas. Br J Surg. 2009;96(1):5-20. doi:10.1002/bjs.6407
  • Elsman BH, de Graaf PW, van Leeuwen MS, Obertop H. De waarde en de risico's van percutane cytologische punctie bij de preoperatieve analyse van pancreastumoren [Value and risks of percutaneous cytological puncture in the preoperative assessment of pancreas tumors]. Ned Tijdschr Geneeskd. 1992;136(30):1459-1462.
  • Civardi G, Fornari F, Cavanna L, Di Stasi M, Sbolli G, Buscarini L. Value of rapid staining and assessment of ultrasound-guided fine needle aspiration biopsies. Acta Cytol. 1988;32(4):552-554.
  • Fornari F, Civardi G, Cavanna L, et al. Complications of ultrasonically guided fine-needle abdominal biopsy. Results of a multicenter Italian study and review of the literature. The Cooperative Italian Study Group. Scand J Gastroenterol. 1989;24(8):949-955. doi:10.3109/00365528909089239
  • Yamaguchi, T., Saisho, H., Otho, M. Usefulness of percutaneous histological biopsy in the diagnosis of chronic pancreatitis with inflammatory mass (CPM). J Interventional Radiology, 1994;(9): 165-170.

Diagnostic Accuracy of Ultrasonography-Guided Percutaneous Core Needle Biopsies of Pancreatic Lesions

Year 2025, Volume: 2 Issue: 2, 100 - 108, 30.06.2025
https://doi.org/10.70058/cjm.1599462

Abstract

Objective
This study evaluates the results and complications of ultrasound-guided percutaneous core needle biopsies for solid masses of the pancreas performed at our university hospital .
Methods
Between January 2009 and June 2013 A total of 60 biopsy procedures were performed in 53 patients (30 males, 23 females) and 11 specimens were benign and 45 specimens were malignant according to histopathologic results.
Results
Sensitivity was 84.9%, specificity was 100% and diagnostic accuracy was 85.7%. No complications were observed during or after biopsy procedures
Conclusion
This study shows that ultrasound-guided biopsy is a reliable, time- and cost-saving method with a very low complication rate, high diagnostic accuracy and sensitivity, but benign biopsy findings should not be used to exclude the presence of pancreatic malignancy and biopsy should be repeated if there is a high clinical suspicion of malignancy.

References

  • Tuncer, M. Kanserin ülkemiz ve dünyadaki önemi, hastalık yükü ve kanser kontrol politikaları. Türkiye’de Kanser Kontrolü, Sağlık Bakanlığı Yayınları. 2009. 707, 5-9.
  • Schneider G, Schmid RM. Genetic alterations in pancreatic carcinoma. Mol Cancer. 2003;2:15. Published 2003 Jan 22. doi:10.1186/1476-4598-2-15
  • TC. Sağlık Bakanlığı 2003 yılı Kanser İstatistikleri. Avaible at: http://www.saglik.gov.tr/extras/istatistikler/apk2003/098.htm -99.htm.
  • Rumack, M.C., Wilson, R.S., Charboneau, J.W., 2011. Diagnostic Ultrasound. 4th edition. Mosby. Philadelphia.
  • American Cancer Society. Cancer facts & figures 2013. Society, A. C. Atlanta, pp. 25.
  • Parker SH, Jobe WE, Dennis MA, et al. US-guided automated large-core breast biopsy. Radiology. 1993;187(2):507-511. doi:10.1148/radiology.187.2.8475299
  • Karlson BM, Forsman CA, Wilander E, et al. Efficiency of percutaneous core biopsy in pancreatic tumor diagnosis. Surgery. 1996;120(1):75-79. doi:10.1016/s0039-6060(96)80244-3
  • Matsubara J, Okusaka T, Morizane C, Ikeda M, Ueno H. Ultrasound-guided percutaneous pancreatic tumor biopsy in pancreatic cancer: a comparison with metastatic liver tumor biopsy, including sensitivity, specificity, and complications. J Gastroenterol. 2008;43(3):225-232. doi:10.1007/s00535-007-2142-9
  • Moossa AR, Altorki N. Pancreatic biopsy. Surg Clin North Am. 1983;63(6):1205-1214. doi:10.1016/s0039-6109(16)43183-x
  • Ingram DM, Sheiner HJ, Shilkin KB. Operative biopsy of the pancreas using the Trucut needle. Aust N Z J Surg. 1978;48(2):203-206. doi:10.1111/j.1445-2197.1978.tb07307.x
  • Turner BG, Cizginer S, Agarwal D, Yang J, Pitman MB, Brugge WR. Diagnosis of pancreatic neoplasia with EUS and FNA: a report of accuracy. Gastrointest Endosc. 2010;71(1):91-98. doi:10.1016/j.gie.2009.06.017
  • Elvin A, Andersson T, Scheibenpflug L, Lindgren PG. Biopsy of the pancreas with a biopsy gun. Radiology. 1990;176(3):677-679. doi:10.1148/radiology.176.3.2167498
  • Paulsen SD, Nghiem HV, Negussie E, Higgins EJ, Caoili EM, Francis IR. Evaluation of imaging-guided core biopsy of pancreatic masses. AJR Am J Roentgenol. 2006;187(3):769-772. doi:10.2214/AJR.05.0366
  • Di Stasi M, Lencioni R, Solmi L, et al. Ultrasound-guided fine needle biopsy of pancreatic masses: results of a multicenter study. Am J Gastroenterol. 1998;93(8):1329-1333. doi:10.1111/j.1572-0241.1998.443_m.x
  • Gress F, Michael H, Gelrud D, et al. EUS-guided fine-needle aspiration of the pancreas: evaluation of pancreatitis as a complication. Gastrointest Endosc. 2002;56(6):864-867. doi:10.1067/mge.2002.129602
  • Smith EH. Complications of percutaneous abdominal fine-needle biopsy. Review. Radiology. 1991;178(1):253-258. doi:10.1148/radiology.178.1.1984314
  • Johnson DE, Pendurthi TK, Balshem AM, et al. Implications of fine-needle aspiration in patients with resectable pancreatic cancer. Am Surg. 1997;63(8):675-680.
  • Hartwig W, Schneider L, Diener MK, Bergmann F, Büchler MW, Werner J. Preoperative tissue diagnosis for tumours of the pancreas. Br J Surg. 2009;96(1):5-20. doi:10.1002/bjs.6407
  • Elsman BH, de Graaf PW, van Leeuwen MS, Obertop H. De waarde en de risico's van percutane cytologische punctie bij de preoperatieve analyse van pancreastumoren [Value and risks of percutaneous cytological puncture in the preoperative assessment of pancreas tumors]. Ned Tijdschr Geneeskd. 1992;136(30):1459-1462.
  • Civardi G, Fornari F, Cavanna L, Di Stasi M, Sbolli G, Buscarini L. Value of rapid staining and assessment of ultrasound-guided fine needle aspiration biopsies. Acta Cytol. 1988;32(4):552-554.
  • Fornari F, Civardi G, Cavanna L, et al. Complications of ultrasonically guided fine-needle abdominal biopsy. Results of a multicenter Italian study and review of the literature. The Cooperative Italian Study Group. Scand J Gastroenterol. 1989;24(8):949-955. doi:10.3109/00365528909089239
  • Yamaguchi, T., Saisho, H., Otho, M. Usefulness of percutaneous histological biopsy in the diagnosis of chronic pancreatitis with inflammatory mass (CPM). J Interventional Radiology, 1994;(9): 165-170.
There are 22 citations in total.

Details

Primary Language English
Subjects Radiology and Organ Imaging
Journal Section Research Articles
Authors

Serkan Yavuz 0009-0005-0434-2790

Ertuğrul Çakır 0000-0002-8057-1262

Behiç Akyüz 0000-0002-3797-8147

Tümay Bekci 0000-0002-3147-2786

Murat Danaci 0000-0001-7785-6139

Publication Date June 30, 2025
Submission Date December 12, 2024
Acceptance Date March 26, 2025
Published in Issue Year 2025 Volume: 2 Issue: 2

Cite

Vancouver Yavuz S, Çakır E, Akyüz B, Bekci T, Danaci M. Diagnostic Accuracy of Ultrasonography-Guided Percutaneous Core Needle Biopsies of Pancreatic Lesions. Cerasus J Med. 2025;2(2):100-8.