| Author/Editor | Tomažič, Aleš | |
| Title | Ocena predoperativne zamejitve periampularnega karcinoma z nekaterimi diagnostičnimi metodami | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Medicinska fakulteta | |
| Publication year | 1998 | |
| Volume | str. 50 | |
| Language | slo | |
| Abstract | Introduction. Cancers of the head of pancreas, of the ampulla Vateri, of the distal common bile duct and of the periampullar part of duodenum are together named as periampullar cancer. Radical resection is the only way of treatment, that is pottentially curable. Preoperative staging is necessary before deciding between paliative or radical treatment. Preoperative staging is assessed with several diagnostic methods, with different overall accuracy, agressiveness, side effects, availability and costs. Materials and methods. Accuracies of ultrasound, computed tomography, endoscopic ultrasound and tumor marker Ca 19-9 , regarding resectability of periampullar cancer, are assessed. We reviewed the records of 43 patients, who were operated because of periampullar cancer. All patients preoperatively underwent ultrasound, abdominal computed tomography and endoscopic ultrasound, and the level of tumor marker Ca 19-9 was assessed. Results. Endoscopic ultrasound has an overall accuracy of 81,4 % in predicting tumor resectability, specificity of 70,8 % and positive predictive value 55,8 %. Computed tomography and tumor marker Ca 19-9 are less accurate, overall accuracy is 69,8 % for both methods, specificity 45,8 % for computed tomography and 84,2 % for CA 19-9, positive predictive value is 40,6 % for computed tomography and 52,6 % for CA 19-9. Ultrasound has an overall accuracy of 51,2 %, specificity of 12,5 % and positive predictive value of 29,7 %. Regarding Cochran Q test there is statisticaly significant difference ( p < 0,05 ) between imaging modalities. Mc Nemar' s test showed also statisticaly significant differences between ultrasound and computed tomography and between ulrasound and endoscopic ultrasound. Statistically significant is also the difference in preoperative staging regarding resectability between computed tomography and combination of computed tomography with endoscopic ultrasound. (Abstract truncated at 2000 characters) | |
| Descriptors | PANCREATIC NEOPLASMS COMMON BILE DUCT NEOPLASMS VATER'S AMPULLA TOMOGRAPHY, X-RAY COMPUTED ENDOSONOGRAPHY CA-19-9 ANTIGEN TREATMENT OUTCOME |