The value of endoscopic ultrasound in the diagnosis and treatment of pancreatic cancer

Pancreatic cancer has the characteristics of low radical resection rate, poor clinical treatment effect, and low 5-year survival rate. Therefore, its early diagnosis is of great value to prognosis.

In recent years, with the application of digestive endoscopy technology in tumor diagnosis and treatment, the early diagnosis rate of pancreatic cancer has gradually increased, especially the ultrasonic endoscope that combines ultrasound with endoscopy, which allows the high-frequency probe to pass through the endoscopic channel close to the gastric and duodenal walls, avoiding echo attenuation and intestinal gas interference, greatly improving the diagnosis rate of early pancreatic cancer.

Reports have shown that endoscopic ultrasound is more accurate than CT and MRI in detecting small pancreatic cancers, and can detect pancreatic masses as small as 5 mm in diameter that cannot be detected by other methods. However, the accuracy of EUS in identifying its performance characteristics decreases as the tumor diameter increases. The accuracy of endoscopic ultrasound in evaluating pancreatic cancers with a diameter of ≤3 cm is 90%, but for those with a diameter of >3 cm, the accuracy is only 30%.

Ultrasound endoscopy can detect the depth and range of tumor infiltration and lymph node metastasis, which is helpful for determining the stage of pancreatic cancer. Among them, the application of small probe intraductal ultrasound has further improved the accuracy of pancreatic cancer diagnosis; experiments have shown that the quantitative endoscopic ultrasound elasticity description method calculates the elasticity quotient value (B/A, where B and A represent the ultrasound elasticity values ​​of the control and pancreatic lesions, respectively), which is significantly higher in pancreatic cancer than in inflammatory masses. The sensitivity and specificity of pancreatic cancer diagnosis are 100% and 92%, respectively, which is helpful for the identification of solid pancreatic masses and the evaluation of hardness.