Ultrason Eşliğinde Perkütan Pankreas Biyopsisinde Tanısal Olmayan Sonuçları Öngören Faktörler

Öz

Bu çalışmada ultrason eşliğinde perkütan pankreas biyopsisinin tanısal başarısını ve güvenlik profilini değerlendirmek ve tanısal olmayan örneklemeyi öngören faktörleri belirlemek amaçlandı. Kasım 2022 ile Mart 2026 tarihleri arasında kliniğimizde ultrason eşliğinde perkütan pankreas biyopsisi uygulanan hastalar retrospektif olarak taranarak çalışmaya dahil edildi. Lezyon özellikleri, biyopsi tekniği, tanısal yeterlilik ve komplikasyonlar değerlendirildi. Tanısal yeterlilik, patolojik değerlendirme için yeterli doku elde edilmesi olarak tanımlandı. Tanısal olan ve tanısal olmayan biyopsiler gruplanarak lezyona ait ve prosedürel parametreler gruplar arası karşılaştırıldı. Tanısal olmayan biyopsi bağımsız prediktörlerini belirlemek amacıyla çok değişkenli lojistik regresyon analizi yapıldı. Toplam 125 hasta (ortalama yaş 66,8 ± 10,4 yıl; %55,2 erkek) çalışmaya dahil edildi. Genel tanısal başarı oranı %78,4 (98/125) olarak bulundu. Tanısal biyopsilerin 79’u malign, 16’sı malignite açısından şüpheli ve 3’ü benign olarak raporlandı. İnce iğne aspirasyon biyopsisi 97 hastada (%77,6), kor biyopsi ise 28 hastada (%22,4) uygulandı. Multivaryant analizde küçük lezyon boyutu (OR: 0,96, %95 GA: 0,93–0,99; p=0,014) ve kistik komponent varlığı (OR: 3,42, %95 GA: 1,21–9,66; p=0,020) tanısal olmayan biyopsi için bağımsız risk faktörü olduğu bulundu. Majör komplikasyon izlenmezken, hastaların %5,6’sında karın ağrısı veya ek tedavi gerektirmeyen hemoraji gibi minör komplikasyonlar görüldü.Sonuç olarak ultrason eşliğinde perkütan pankreas biyopsisi kabul edilebilir tanısal performansa sahip güvenli ve etkili bir yöntemdir. Lezyon boyutu ve kistik komponent varlığı tanısal başarıyı etkileyen önemli faktörler olup işlem planlamasında dikkate alınmalıdır.

Anahtar Kelimeler

• Pankreas neoplazmları
• Görüntüleme kılavuzluğunda biyopsi
• İnce iğne aspirasyon biyopsisi

Factors Predicting Non-diagnostic Results in Ultrasound-Guided Percutaneous Pancreatic Biopsy

Öz

The present study aimed to evaluate the diagnostic adequacy and safety profile of ultrasound-guided percutaneous pancreatic biopsy and to determine predictors of non-diagnostic results. In this retrospective single-center study, consecutive patients who underwent ultrasound-guided percutaneous pancreatic biopsy between November 2022 and March 2026 were included. Lesion characteristics, biopsy technique, diagnostic adequacy, and complications were evaluated. Diagnostic adequacy was defined as obtaining sufficient tissue for pathological evaluation. Diagnostic and non-diagnostic biopsies were grouped, and lesion-related and procedural parameters were compared between the groups. Multivariable logistic regression analysis was performed to identify independent predictors of non-diagnostic biopsy. A total of 125 patients (mean age, 66.8 ± 10.4 years; 55.2% male) were included in the study. The overall diagnostic adequacy was 78.4% (98/125). Among diagnostic biopsies, 79 were reported as malignant, 16 as suspicious for malignancy, and 3 as benign. Fine-needle aspiration biopsy was performed in 97 patients (77.6%), whereas core needle biopsy was performed in 28 patients (22.4%). In multivariable analysis, smaller lesion size (OR: 0.96, 95% CI: 0.93–0.99; p=0.014) and the presence of a cystic component (OR: 3.42, 95% CI: 1.21–9.66; p=0.020) were identified as independent risk factors for non-diagnostic biopsy. No major complications were observed, while minor complications, including abdominal pain or hemorrhage not requiring additional treatment, occurred in 5.6% of patients. In conclusion, ultrasound-guided percutaneous pancreatic biopsy is a safe and effective method with acceptable diagnostic adequacy. Lesion size and the presence of a cystic component are important factors affecting diagnostic adequacy and should be considered during procedural planning.

Anahtar Kelimeler

• Pancreatic neoplasms
• Image-guided biopsy
• Biopsy
• Fine-Needle

Kaynakça

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