肿瘤细胞Vimentin联合超声内镜引导细针穿刺活检术对胰腺实性肿瘤的诊断价值

Diagnostic value of tumor cell Vimentin combined with endoscopic ultrasound-guided fine-needle biopsy for solid pancreatic tumors

摘要:

目的 评估肿瘤细胞Vimentin联合超声内镜引导细针穿刺活检术（EUS-FNB）诊断胰腺实性肿瘤的应用效果。方法 回顾性分析2021年10月－2023年12月该院接受EUS-FNB的110例患者的临床资料，胰腺实性肿瘤包括但不限于胰腺癌和胰腺神经内分泌肿瘤。通过对比EUS-FNB与最终病理学诊断结果，评估其敏感度、特异度和准确性。结果 获得明确组织病理学诊断的106例，占96.37%。其中，87例明确诊断为腺癌或胰腺导管腺癌。免疫组织化学染色结果显示，Vimentin在肿瘤细胞中表达；不同部位穿刺病理阳性率比较，差异无统计学意义（P > 0.05），不同直径病灶穿刺病理阳性率比较，差异有统计学意义（P < 0.05）。免疫组织化学染色结果显示，Vimentin的表达水平可能与病变的性质相关。Vimentin联合EUS-FNB诊断胰腺占位性病变的总体准确率为86.09%，敏感度为84.57%，特异度为100.00%。在实性占位方面，诊断准确率达到87.67%，特异度为100.00%，敏感度为86.55%。对于胰腺囊性肿瘤，诊断准确率为65.42%，特异度为100.00%，敏感度为69.79%。结论 肿瘤细胞Vimentin联合EUS-FNB诊断胰腺实性肿瘤的准确率高，值得临床应用。

Abstract:

Objective To evaluate the effectiveness of tumor cell Vimentin combined with endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in diagnosing solid pancreatic tumors.Methods Clinical data from 110 patients who underwent EUS-FNB from October 2021 to December 2023 were retrospectively analyzed. Solid pancreatic tumors including but not limited to pancreatic cancer and pancreatic neuroendocrine tumors. The sensitivity, specificity, and accuracy of EUS-FNB were assessed by comparing its results with the final pathological diagnoses.Result Clear histopathological diagnoses were obtained in 106 cases, accounting for 96.37%. Among them, 87 cases were definitively diagnosed as adenocarcinoma or pancreatic ductal adenocarcinoma. Immunohistochemical staining showed that Vimentin was expressed in the tumor cells. There was no statistically significant difference in positive rates among biopsies from different anatomical sites (P > 0.05), but significant differences were observed in lesions of different diameters (P < 0.05). Immunohistochemical staining suggested that Vimentin expression levels might be associated with the nature of the lesions. The overall diagnostic accuracy, sensitivity, and specificity of Vimentin combined with EUS-FNB for pancreatic masses were 86.09%, 84.57%, and 100.00%, respectively. Specifically, for solid masses, the diagnostic accuracy, sensitivity, and specificity were 87.67%, 86.55%, and 100.00%, respectively. For pancreatic cystic tumors, the diagnostic accuracy, sensitivity, and specificity were 65.42%, 69.79%, and 100.00%, respectively.Conclusion The combination of tumor cell Vimentin and EUS-FNB demonstrates high diagnostic accuracy for solid pancreatic tumors, making it a valuable tool for clinical application.