The application of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy in diagnosis of pancreatic neoplasms / 中华消化内镜杂志

ABSTRACT

Objective To discuss the application of endoscopic ultrasound-guided needle-based confocal laser endomicroscopy ( EUS-nCLE) in the diagnosis of pancreatic neoplasms. Methods Patients with pancreatic neoplasms were diagnosed by endoscopic ultrasonography and punctured by 19 G needle, and then the confocal microprobe was implanted through the needle. The lesions nature was estimated according to obtained images. The diagnostic yield and complication was evaluated and compared with pathology. Results A total of 28 patients successfully underwent EUS-nCLE, and high quality images were obtained in all patients. The final diagnosis were 5 cases of serous cystadenoma ( SCN ) , 3 cases of mucinous cystadenoma, 3 cases of intraductal papillary mucinous neoplasms ( IPMN) , 1 case of pseudocyst, 10 cases of ductal adenocarcinoma, 1 case of neuroendocrine tumor, 2 cases of solid pseudopapillary tumor, 2 cases of chronic pancreatitis, and 1 cases of lymphoma. The diagnostic yield in 26 patients with pathology was 73. 1%(19/26) and the specificity of SCN and IPMN was 100%(7/7). The complications, mostly pancreatitis and intracystic hemorrhage, occurred in 10. 7% ( 3/28) patients. Conclusion EUS-nCLE is a safe and feasible method in the diagnosis of pancreatic neoplasms, and shows high specificity in SCN and IPMN.