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中华腔镜外科杂志(电子版) ›› 2021, Vol. 14 ›› Issue (05) : 293 -297. doi: 10.3877/cma.j.issn.1674-6899.2021.05.008

论著

基于新评价体系的胰腺囊性肿瘤消融有效性分析
宁波1, 柴宁莉1, 李惠凯1, 冯秀雪1, 杜晨1, 李笑2, 张晓彬1, 赵鑫3, 令狐恩强1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心消化内科医学部
    2. 100853 北京,解放军总医院第一医学中心消化内科医学部;100853 北京,解放军医学院
    3. 100853 北京,解放军总医院第一医学中心消化内科医学部;300071 天津,南开大学医学院
  • 收稿日期:2021-08-15 出版日期:2021-10-30
  • 通信作者: 令狐恩强

The efficacy of EUS-LA in the treatment of PCNs under the new evaluation system

Bo Ning1, Ningli Chai1, Huikai Li1, Xiuxue Feng1, Chen Du1, Xiao Li2, Xiaobin Zhang1, Xin Zhao3, Enqiang Linghu1,()   

  1. 1. Senior Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China
    2. Senior Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing 100853, China
    3. Senior Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China; Nankai University School of Medicine, Nankai University, Tianjin 300071, China
  • Received:2021-08-15 Published:2021-10-30
  • Corresponding author: Enqiang Linghu
引用本文:

宁波, 柴宁莉, 李惠凯, 冯秀雪, 杜晨, 李笑, 张晓彬, 赵鑫, 令狐恩强. 基于新评价体系的胰腺囊性肿瘤消融有效性分析[J/OL]. 中华腔镜外科杂志(电子版), 2021, 14(05): 293-297.

Bo Ning, Ningli Chai, Huikai Li, Xiuxue Feng, Chen Du, Xiao Li, Xiaobin Zhang, Xin Zhao, Enqiang Linghu. The efficacy of EUS-LA in the treatment of PCNs under the new evaluation system[J/OL]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2021, 14(05): 293-297.

目的

对超声内镜引导下聚桂醇注射消融术(endoscopic ultrasonography-guided lauromacrogol ablation, EUS-LA)治疗胰腺囊性肿瘤(panceratic cystic neoplasms,PCNs)的有效性进行分析。

方法

前瞻性地纳入2015年4月至2021年7月解放军总医院第一医学中心85例行EUS-LA的PCNs患者,基于新评价体系对其中随访的75例进行有效性分析。完全消失定义为最终体积=0,接近完全消失定义为0<最终体积≤10%原始体积,显著有效为10%原始体积<最终体积≤25%原始体积,有效定义为25%原始体积<最终体积≤75%原始体积,稳定定义为75%原始体积<最终体积≤100%原始体积,进展定义为最终体积>100%原始体积。

结果

新方法评价体系下评价初次有效性:完全消失25例(33.3%)、接近完全消失12例(16.0%)、显著有效15例(20.0%)、有效10例(13.3%)、稳定10例(13.3%)、进展3例(4.0%);总体有效性:完全消失28例(37.3%)、接近完全消失15例(20.0%)、显著有效12例(16.0%)、有效7例(9.3%)、稳定9例(12.0%)、进展4例(5.3%)。

结论

在新评价体系下初次消融病变缩小有效率和总体消融病变缩小有效率均得到提高,其不仅能评价病变不同程度体积缩小所产生的效果,而且能描述病变增大所产生的进展趋势。

Objective

To evaluate the efficacy of endoscopic ultrasonography-guided lauromacrogol ablation (EUS-LA) in the treatment of pancreatic cystic tumors (PCNs).

Methods

From Apr. 2015 to Jul. 2021, 85 patients treated with EUS-LA were enrolled in the First Medical Center of PLA General Hospital, and 75 of them were followed up for validity analysis based on the new evaluation system. The definitions are as follows, complete disappearance, final volume (FV) = 0; nearly complete disappearance , 0 < FV ≤ 10% original volume (OV); significantly effective, 10%< FV ≤ 25% OV; effective, 25%OV< FV ≤ 75% OV; stabilization, 75%OV< FV ≤ 100% OV; progress > 100% OV.

Results

The initial effectiveness of the new evaluation system was as follows: complete disappearance in 25 cases (33.3%), nearly complete disappearance in 12 cases (16.0%), significantly effective in 15 cases (20.0%), effective in 10 cases (13.3%), stabilization in 10 cases (13.3%), progress in 3 cases (4.0%). The overall effectiveness of the new evaluation system was as follows: 28 cases (37.3%) complete disappearance, 15 cases (20.0%) nearly complete disappearance, 12 cases (16.0%) significantly effective, 7 cases (9.3%) effective, 9 cases (12.0%) stabilization, 4 cases (5.3%) progress.

Conclusions

Based on the new evaluation system, both the effective rate of initial and total lesion reduction were improved, which could not only evaluate the effect of different degree of lesion reduction, but also describe the progressive trend of lesion enlargement.

表1 随访到75例胰腺囊性肿瘤患者初次有效性和总体有效性[例(%)]
图1 超声内镜引导下聚桂醇注射消融术后病变完全消失
表2 随访到75例胰腺囊性肿瘤患者初次消融后病变减小的单因素分析
1
Oh HC, Seo DW, Lee TY,et al. New treatment for cystic tumors of the pancreas: EUS-guided ethanol lavage with paclitaxel injec tion[J].Gastrointest Endosc, 200867(4): 636-642.
2
中华胰腺病杂志编辑委员会.我国胰腺囊性肿瘤共识意见(草案2013,上海) [J].中华胰腺病杂志, 201313(2): 79-90.
3
DeWitt J. Endoscopic ultrasound-guided pancreatic cyst ablatior[J].Gastrointest Endosc Clin N Am, 201222(2): 291-302.
4
Goh BK, Tan YM, Cheow PC, et al. Cystic lesions of the pancreas: an appraisal of an aggressive resectional policy adopted al a single institution during 15 years[J].Am J Surg, 2006, 192(2): 148-154.
5
Galanis C, Zamani A, Cameron JL, et al. Resected serous cystic neoplasms of the pancreas:a review of 158 patients with recom mendations for treatment[J]. J Gastrointest Surg, 200711(7): 820-826.
6
Kiely JM, Nakeeb A, Komorowski RA, et al, Cystic pancreatic neoplasms:enucleate or resect[J].J Gastrointest Surg, 20037(7): 890-897.
7
Linghu E, Du C, Chai N, et al. A prospective study on the safety and effectiveness of using lauromacrogol for ablation of pancreatic cystic neoplasms with the aid of eus[J].Gastrointest Endosc201786(5): 872-880.
8
杜晨,令狐恩强,柴宁莉,等.超声内镜引导下聚桂醇消融术治疗胰腺囊性肿瘤安全性及有效性的前瞻性研究[J/CD].中华胃肠内镜电子杂志20174(1): 1-5.
9
杜晨,郭旭,杨晶,等.胰腺囊性肿瘤内镜超声引导下聚桂醇消融术的前瞻性研究[J].中华消化内镜杂志201734(9): 653-657.
10
DeWitt J, McGreevy K, Schmidt CM, et al. EUS-guided ethanol versus saline solution lavage for pancreatic cysts: a randomized, double-blind study[J].Gastrointest Endosc, 200970(4): 710-723.
11
Oh HC, Seo DW, Kim SC,et al. Septated cystic tumors of the pancreas: is it possible to treat them by endoscopic ultrasonogra-phy-guided intervention[J].Scand J Gastroenterol, 200944(2): 242-247.
12
DeWitt J, DiMaio CJ, Brugge WR. Long-term follow-up of pancreatic cysts that resolve radiologically after eus-guided ethanal ablation[J].Gastrointest Endosc201072(4): 862-866.
13
DiMaio CJ, DeWitt JM, Brugge WR. Ablation of pancreatic cystic lesions: the use of multiple endoscopic ultrasound-guided ethanol lavage sessions[J].Pancreas, 201140(5): 664-668.
14
Pai M, Habib N, Senturk H,et al. Endoscopic ultrasound guided radiofrequency ablation, for pancreatic cystic neoplasms and neuroendocrine tumors[J].World J Gastrointest Surg20157(4): 52-59.
15
Moris M, Atar M, Kadayifci A,et al. Thermal ablation of pancreatic cyst with a prototype endoscopic ultrasound capable radio- frequency needle device: a pilot feasibility study[J]. Endosc Ultrasound20176(2): 123-130.
16
Oh HC, Seo DW, Song TJ,et al. Endoscopic ultrasonography guided ethanol lavage with paclitaxel injection treats patients with pancreatic cysts[J]. Gastroenterology2011140(1): 172-179.
17
DeWitt JM, Al-Haddad M, Sherman S, et al. Alterations in cyst fluid genetics following endoscopic ultrasound-guided pancreatic cyst ablation with ethanol and paclitaxel[J].Endoscopy, 201446(6): 457-464.
18
Moyer MT, Sharzehi S, Mathew A, et al. The safety and efficacy of an alcohol-free pancreatic cyst ablation protocol[J].Gastroenterolog2017153(5): 1295-1303.
19
Gan SI, Thompson CC, Lauwers GY,et al. Ethanol lavage of pancreatic cystic lesions: initial pilot study[J]. Gastrointest Endosc200561(6): 746-752.
20
Park JK, Song BJ, Ryu JK,et al. Clinical outcomes of endoscopic ultrasonography-guided pancreatic cyst ablation[J]. Pancreas201645(6): 889-894.
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