Úvod: Pankreatické cystické lézie (PCL) sú diagnostikované čoraz častejšie a niektoré majú malígny potenciál. Rozhodnutie o indikácii endosonografickej tenkoihlovej aspirácie (EUS-FNA) a resekcie zostáva stále výzvou. Ciele: Zhodnotiť realizovateľnosť a diagnostický prospech EUS--FNA, a u pacientov podstupujúcich chirurgickú resekciu, porovnať výsledky EUS-FNA s resekčnou histológiou. Metódy: Retrospektívna observačná štúdia u pacientov podstupujúcich EUS-FNA pre PCL. Hodnotili sme morfologické rizikové znaky: solídny komponent, nástenný uzol > 5 mm, rozšírený pankreatický vývod > 5 mm, veľkosť lézie > 4 cm. Mucinózna lézia bola definovaná makroskopicky pozitívnym string testom, hustým mucínom a/alebo vysokým CEA (> 100 ng/ml) alebo nízkou hladinou glukózy (< 2,8 mmol/l). Získaný materiál bol natretý na podložné sklíčka a odoslaný na cytológiu. Výsledky: Zahrnuli sme 30 pacientov, pomer M/Ž bol 20/10, priemerný vek bol 66,5 (IQR 58–73) rokov. Sedemnásť pacientov malo 1 a viac rizikových znakov, 13 nemalo žiadne. Makroskopické hodnotenie tekutiny bolo úspešné u 23 (76,6 %) pacientov, bolo pozitívne u 14 (skupina M) a negatívne u 9 pacientov (skupina N). Analýza tekutiny ukázala predpokladanú mucinóznu léziu u všetkých pacientov v skupine M a u štyroch (44,4 %) v skupine N. Desať pacientov podstúpilo chirurgickú resekciu. V porovnaní s resekčnou histológiou mala prítomnosť najmenej jedného rizikového znaku 100% senzitivitu a 42,8% špecificitu na diagnostiku high-grade neoplázie, tekutinová analýza mala 71,4% senzitivitu a 66,6% špecificitu pre mucinóznu léziu a cytologické hodnotenie malo 0% senzitivitu a 66,6% špecificitu pre high-grade neopláziu. Záver: Naša štúdia poskytuje pohľad na diagnostickú komplexnosť PCL. Ukazuje, že pacientov bez morfologických rizikových znakov je možné bezpečne sledovať a EUS-FNA je potrebná pri léziách s 1 alebo viacerými rizikovými znakmi. Lézie s mucinóznou tekutinou a rizikovým znakom by mali byť indikované na resekciu pre vysoké riziko malignity.
Background: Pancreatic cystic lesions (PCLs) are being more frequently diagnosed and some have the potential for malignant transformation. The decision for performing EUS-FNA and indicating surgery remains challenging. Aims: To evaluate the feasibility and diagnostic yield of EUS-FNA, and in patients undergoing surgery to compare results of EUS-FNA with the resection histology. Methods: A retrospective observational study in patients undergoing EUS-FNA for PCLs. We assessed morphological risk features: solid component, a mural nodule >5 mm, dilated pancreatic duct >5 mm, lesion size >4 cm. The mucinous content was defined macroscopically by positive string test/thick mucin and/or by high CEA (>100 ng/ml) or low glucose (<2.8 mmol/l). Aspirated material was smeared and sent for cytology. Results: We included 30 patients, an M/F ratio of 20/10, with a median age of 66.5 (IQR 58–73) years. Seventeen patients had one or more risk features, 13 had none. The macroscopic evaluation of fluid was reported in 23 (76.6%) patients, it was positive in 14 (Group M) and negative in nine patients (Group N). The fluid analysis showed a presumed mucinous lesion in all patients in Group M, and four (44.4%) in Group N. Ten patients underwent surgery. Compared with resection histology, the presence of at least one risk feature had 100% sensitivity and 42.8% specificity for diagnosing high-grade neoplasia, the fluid analysis had 71.4% sensitivity and 66.6% specificity for a mucinous lesion, and cytological evaluation had 0% sensitivity and 66.6% specificity for high-grade neoplasia. Conclusion: Our study provides insight into the diagnostic complexity of PCLs. Our experience supports safe follow-up in patients without morphological risk features, and EUS-FNA indication in lesions with one or more risk features. Due to the high risk of malignancy, presumed mucinous lesions with a risk feature should be referred for surgery.
... Data Transformations 147 -- 6.1 Splitting a Vector into Groups 148 -- 6.2 Applying a Function to Each ... ... Strings and Dates 161 -- 7.1 Getting the Length of a String 163 -- 7.2 Concatenating Strings 163 -- 7.3 ... ... 166 -- Table of Contents | vii -- 7.6 Seeing the Special Characters in a String 167 -- 7.7 Generating ... ... All Pairwise Combinations of Strings 168 -- 7.8 Getting the Current Date 169 -- 7.9 Converting a String ... ... into a Date 170 -- 7.10 Converting a Date into a String 171 -- 7.11 Converting Year, Month, and Day ...
1st ed. xviii, 413 s. : il. ; 24 cm
- Keywords
- systém R, R software,
- MeSH
- Electronic Data Processing MeSH
- Software MeSH
- Statistics as Topic MeSH
- Publication type
- Monograph MeSH
- Handbook MeSH
... Chart 16 -- Descriptive Statistics, Percentiles, Quartiles, and a Histogram 21 -- Using Data Transformations ... ... Compare Means 103 -- Two-Sample T Tests with Numeric Codes for Climate 105 -- Two-Sample T Tests with String ...
[1st ed.] xi, 412 s.
... Random Grammars: Models of Functional Integration and Transformation, 369 -- Jets and Autocatalytic Sets ... ... : Toward a New String Theory, 372 Infinite Boolean Networks and Random Grammars: Approaches to Studying ... ... Families of Mappings of Strings into Strings, 377 Applications to Biological, Neural, and Economic Systems ...
1st ed. 709 s. : il.
- Keywords
- Biologie, Evoluce, Fylogeneze,
- MeSH
- Biological Evolution MeSH
- Biology MeSH
- Phylogeny MeSH
- Evolution, Molecular MeSH
- Origin of Life MeSH
- Conspectus
- Obecná genetika. Obecná cytogenetika. Evoluce
- NML Fields
- molekulární biologie, molekulární medicína
... the Genetic Material 220 Proof That Genetic Information Is Stored in DNA 220 -- Discovery of Transformation ... ... in Bacteria 220 Proof That DNA Mediates Transformation 222 Proof That DNA Carries the Genetic Information ... ... Genetic Exchange in Bacteria: An Overview 454 Mutant Phenotypes in Bacteria 455 Basic Test for Transformation ... ... , Conjugation, and Transduction 456 Transformation 457 -- The Process of Transformation 457 Transformation ... ... Barbara McClintock, The Discoverer of Transposable Elements 478 Technical Sidelight: Genetic Transformation ...
2nd ed. xviii, 876 s. : il.
