Author/Editor		Tomažič, Aleš
Title		Ocena predoperativne zamejitve periampularnega karcinoma z nekaterimi diagnostičnimi metodami
Translated title		Preoperative staging of periampullar cancer with US, CT, EUS and Ca 19-9
Type		članek
Source		Gastroenterolog
Vol. and No.		Letnik 5, št. 1
Publication year		2001
Volume		str. 25-7
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 periampullar cancer Radical resection is the only way of treatment, that is potentially 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 199 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 ultrasound 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)
Summary		Uvod. Karcinome glave pankreasa, ampule Vateri, distalnega holedohusa in periampularnega dela dvanajstnika označujemo s skupnim imenom periampularni karcinomi. Radikalna resekcija je edini način zdravljenja, ki bolnikom: pomeni upanje na ozdravitev. Pri odločanju o paliativnem ali radikalnem zdravljenju je bistvena predoperativna zamejitev tumorjev, ki jo lahko ocenjujemo s številnimi preiskavnimi metodami. Diagnostične metode se med seboj razlikujejo v natančnosti, invazivnosti, stranskih učinkih, zahtevnosti, dostopnosti in ceni. Materiali in metode. V nalogi sem ocenil natančnost ultrazvoka, računalniške tomografije, endoskopskega ultrazvoka in ravni tumorskega označevalca Ca 19-9 glede ocene resektabilnosti.periampularnih karcinomov. V nalogo je bilo zajetih 43 bolnikov, ki so bili operirani na Kliničnem oddelku za abdominalno kirurgijo Kliničnega centra v Ljubljani in so imeli pred operacijo narejene vse naštete preiskave. (Izvleček skrajšan pri 2000 znakih)
Descriptors		PANCREATIC NEOPLASMS NEOPLASM STAGING ENDOSONOGRAPHY TOMOGRAPHY, X-RAY COMPUTED TUMOR MARKERS, BIOLOGICAL