Role of endoscopic ultrasound in primary staging and vascular assessment of pancreatic cancer

Mohammed Ali Ahmed El-Nady,Mustafa Ahmed Haridy,Amro Metwally Hassan, Saad Rizk Abdelwahid,Mohammed Fakhry Mohammed, Khalid Abdelazeem Ead

Research Square (Research Square)(2022)

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摘要
Abstract Background: computed tomography (CT) of the abdomen with contrast is the gold standard method for primary evaluation of pancreatic cancer as regard to staging and vascular assessment. however, not all patients can be evaluated by contrast enhanced CT abdomen as those with allergy to the contrast agent, pregnancy, renal impairment, in addition to hazards of radiation and non-availability of tissue sampling in CECT abdomen .so this study was designed to evaluate the diagnostic ability of Endoscopic Ultrasound for staging and vascular assessment of pancreatic cancer in comparison to CT abdomen with contrast. Method: fifty patients with cancer pancreas were evaluated by EUS as regard staging and vascular invasion. Vascular assessment was done by dividing the EUS findings into three types in accordance with the relationship between tumors and major vessels, type 1, clear invasion, encasement of vessel by a tumor or tumor that contact a vessel wall more than 180o; type2, Abutment, a tumor that contacts a vessel wall but less than 180o and type 3, clear non-invasion, existence of distance between a tumor and a vessel. We regarded types 1 and type 2 as signs of vascular invasion and types 3 as sign of vascular non-invasion, these findings were compared with the findings of CT abdomen with contrast. The endoscopist was blind to CT result before EUS examination. Result: as regard to staging of pancreatic cancer EUS showed sensitivity, specificity and accuracy of 100% for all. and as regard vascular invasion EUS showed sensitivity, specificity and accuracy of 100% ,95.93% and 96% respectively for venous invasion and 95.65% ,100% and 99.5% for arterial invasion. Conclusion: EUS can evaluate staging and vascular invasion of pancreatic cancer with very high sensitivity, specificity and accuracy to the extend it can replace CT in primary evaluation, with superiority of EUS due to tissue sampling.
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关键词
endoscopic ultrasound,pancreatic cancer,vascular assessment
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