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OBJECTIVE To evaluate the cost -effectiveness of tislelizumab in the second -line treatment of advanced or metastatic esophageal squamous cell carcinoma （ESCC）in China .METHODS A three -state Markov model was constructed to assess the cost -effectiveness of tislelizumab versus chemotherapy in the second -line treatment of advanced or metastatic ESCC and programmed death receptor 1（PD-L1）positive patients . The cycle length of the model was 1 month，and the time horizon of the model was set as 10 years. The discount rate of cost and utility was 5%. One-way sensitivity analysis ，probability sensitivity analysis and scenario analysis were used to verify the robustness of the base -case analysis results . RESULTS The results of the base-case analysis showed that compared with chemotherapy ，the incremental cost -effectiveness ratio （ICER）of tislelizumab in the second-line treatment of advanced or metastatic ESCC and PD -L1-positive patients were 26 864.01 yuan/QALY and 37 510.07 yuan/QALY，respectively，which was much lower than 1 time per capita gross domestic product （GDP）in 2021（80 976 yuan）. Results of scenario analysis showed that the ICER was less than 1 times per capita GDP ，regardless of the chemotherapy regimens（paclitaxel，docetaxel or irinotecan ）used. With the extension of the simulation time limit ，the ICER of tirelizumab regimen gradually decreased ，and the reduction rate gradually E-mail：lishunping@sdu.edu.cn decreased，but they were all less than 1 time China ’s per capita GDP in 2021. The results of the one -way sensitivity analysis showed that the 3 parameters with the most significant impact on the ICER were progression -free survival of tislelizumab group ，price of tislelizumab ，and the proportion of patients receiving follow-up treatment in the tislelizumab group . The results of the probability sensitivity analysis showed that the probability of tislelizumab with cost -effectiveness in the treatment of advanced or metastatic ESCC patients and PD -L1-positive patients were 99.09% and 99.94%，respectively，when using 3 times per capita GDP as the willingness -to-pay threshold . CONCLUSIONS Tislelizumab has economic advantages over chemotherapy alone in the second -line treatment of advanced or metastatic ESCC patients.
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Glioma is a common tumor in the central nervous system. Because the natural immunosuppression of tumor microenvironment is conducive to tumor growth, transformation and migration, the traditional treatment has little effect and is difficult to make a breakthrough. Glioma-associated microglia and macrophage (GAM), an important part of brain tumor microenvironment, plays a more and more key role in tumor progression and regulation of anti-tumor immune response. This article reviews the latest progress of the source, recruitment, polarization and the role in development of gliomas as well as potential therapeutic targets of gliomas.
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As a new direction of pancreatic cancer treatment, neoadjuvant therapy for pancreatic cancer has been confirmed to be able to improve the prognosis of the patients. Under multidisciplinary treatment (MDT) mode, neoadjuvant therapy combines multidisciplinary advantages to solve patients′ problems of diagnosis and treatment, provides accurate, comprehensive and individual treatments, and maximizes the clinical benefit for patients. In this article, we summarize the present problems of neoadjuvant therapy for pancreatic cancer in patient selection, treatment regimen selection, treatment response evaluation and surgical selection, and explore the direction of clinical research and neoadjuvant therapy for pancreatic cancer under MDT mode.
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Pancreatic cancer is a gastrointestinal tumor with a high degree of malignancy. It is difficult to treat and often has poor prognosis, and therefore, it has always been a clinical challenge. Endoscopic ultrasound-guided interstitial implantation of radioactive seeds and gold fiducial markers are both innovative techniques which combine interventional ultrasonography and radiotherapy and are used for the treatment of pancreatic cancer to realize the concentrated radioactive treatment of pancreatic tumors. This article reviews the advances in the application and research of these two techniques, hoping that more studies can be conducted in the future to help it play a greater role in the treatment of pancreatic cancer.
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Objective:To evaluate the comprehensive strength of the specialties included in the medical service capacity improvement project of Henan provincial medical and health institutions, analyze the influencing factors, and provide scientific basis for the specialty construction.Methods:A total of 52 specialties were included in the project. According to the content of construction assessment and acceptance, the questionnaire was designed and filled in by the persons in charge of the specialties from the aspects of basic conditions, medical technical team, medical service ability, medical quality, scientific research and teaching ability. TOPSIS method was used to evaluate the comprehensive strength of specialty, and the main influencing factors were analyzed by single factor analysis, Mann-Whitney U test, correlation analysis and multiple stepwise regression analysis. Results:The research and teaching ability of the specialties had the strongest correlation with the comprehensive strength of the specialties. The scientific research and teaching ability was strongly related to the medical service ability. The number of people holding the post of academic institutes at or above provincial level, the number of industry standards or national guidelines, the number of academic conferences hosted at or above the provincial level, the number of postgraduate training, the number of papers published in SCI and core journals were the main influencing factors of scientific research and teaching ability.Conclusions:It is necessary to improve the level of scientific research and teaching in key specialty to promote the improvement of medical service ability. We should pay more attention to the construction of high-level talents, the cultivation of research-oriented talents, the application of new medical technology and original research.
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Objective:To understand the output of research and education of clinical key Specialties in Henan Province, to analyze the current situation and existing problems, and to provide scientific evidence and suggestions for the improvement of specialist ability.Methods:Through the questionnaire survey to collect the scientific research data of key specialties from 2015 to 2019, apply Epidata 3.0 to input the data, use SPSS 21.0 software to carry out test and Mann Whitney U test, and carry out a comparative analysis of the national and provincial clinical key specialty discipline leaders, medical talent team, academic, scientific research and education output in Henan Province. Results:Academic literacy and scientific research ability of leaders of national and provincial key clinical specialties in Henan Province are equal. However, there is still a big gap in scientific research and education ability between national and provincial key clinical specialties in Henan Province.Conclusions:The provincial key clinical specialties need to improve the ability of scientific research and education in a more holistic way, further strengthen the medical talents team, and focus on the exchange of high-level academic platform and the cultivation of research talents.
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Objective@#To evaluate the efficacy and safety of a novel lumen-apposing metal stent(LAMS) in endoscopic ultrasonography(EUS)-guided transgastric drainage of pancreatic fluid collections(PFC).@*Methods@#A retrospective study of 46 patients was performed who underwent EUS-guided transgastric drainage of PFC with placement of LAMS from September 2015 to April 2017. Clinical data were reviewed and follow-up data were obtained by telephone and outpatient contact.@*Results@#A total of 49 LAMS were placed in 46 patients (2 LAMS were placed in 3 patient respectively for multiport access). The operation success rate was 95.9%(47/49), complications occurred in 14 patients(31.8%), including 2 severe complications (delayed hemorrhage and peritonitis). Additional intervention was performed in 10 patients(22.7%). The mean hospital stay was 6 days (1-40 days) and patients were followed for a mean time of 18.4 months (9-28 months). Treatment success was achieved in 40 patients(90.9%). Stent removal was performed after a mean time of 59.4 days (20-142 days), and recurrence rate was 10%(4/40) during the follow-up period.@*Conclusion@#Drainage of PFC using LAMS with special design is effective and relatively safe.
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Objective To evaluate the efficacy and safety of a novel lumen-apposing metal stent (LAMS) in endoscopic ultrasonography(EUS)-guided transgastric drainage of pancreatic fluid collections (PFC). Methods A retrospective study of 46 patients was performed who underwent EUS-guided transgastric drainage of PFC with placement of LAMS from September 2015 to April 2017. Clinical data were reviewed and follow-up data were obtained by telephone and outpatient contact. Results A total of 49 LAMS were placed in 46 patients ( 2 LAMS were placed in 3 patient respectively for multiport access ) . The operation success rate was 95. 9％( 47/49 ) , complications occurred in 14 patients ( 31. 8％) , including 2 severe complications ( delayed hemorrhage and peritonitis ) . Additional intervention was performed in 10 patients(22. 7％). The mean hospital stay was 6 days (1-40 days) and patients were followed for a mean time of 18. 4 months ( 9-28 months) . Treatment success was achieved in 40 patients( 90. 9％) . Stent removal was performed after a mean time of 59. 4 days ( 20-142 days) , and recurrence rate was 10％( 4/40) during the follow-up period. Conclusion Drainage of PFC using LAMS with special design is effective and relatively safe.
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Objective To study the development of the first county-level key clinical specialized talent teams in Henan province. Methods Data on the first 30 county-level key clinical specialized talent teams were collected through questionnaire in 2014 and 2017 respectively, and signed rank sum test was conducted to analyze such facts as the changes of medical service volume, academic titles and scientific researches of discipline leaders before and after such construction. McNemar′s test and chi-square test were conducted to study the age structure, seniority, education and technical title makeup of these discipline leaders. Such tests were also conducted to study the age structure, seniority, education and technical title makeup of the talents. These efforts aim to discern the construction achievement of the key clinical specialties. Results The indexes of healthcare capacities of the first batch of clinical key specialties were observed as improved ( P <0. 05 ) in terms of the medical service volume. Of the discipline leaders′ age structure, the 51 -60 age groups accounted for 40. 0％ and 66. 7％ respectively, before and after the construction, scoring a difference of statistical significance ( P <0. 05 ); the number of senior physicians increased by 80 persons, the number of physicians having master or above titles increased by 40 persons;the number of physicians participating in continuing education held by these specialties grew from 146. 50 to 262. 50(P<0. 05). Conclusions The volume of medical service of the first batch of county-level clinical key specialties has been elevated, and a group of talents of high education and senior titles have been recruited. Whereas, the title structure needs to be improved, and more young academic leaders are expected, while more opportunities of further education and training are also expected for the physicians, in order to enhance their professional ability.
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Objective To evaluate the efficacy of endoscopic ultrasonography-guided celiac plexus radiation with iodine-125 (125I) seeds and celiac plexus neurolysis with absolute ethanol for pain relief secondary to advanced pancreatic cancer.Methods A retrospective analysis of 43 patients of advanced pancreatic cancer with moderate to severe abdominal pain in the Department of Gastroenterology,Shanghai Changhai Hospital from January 2017 to April 2018 was performed.20 patients underwent EUS-guided celiac plexus neurolysis (CPN),and 23 patients underwent EUS-guided celiac plexus radiation (CPR) with the implantation of 125I seeds around the celiac ganglia.The postoperative VAS score of abdominal pain,mean analgesic (MS Contin [morphine sulfate]) consumption and complications were compared between the two groups.Results There were no statistically significant differences between the two groups in the sex ratio (male/female,10/10 vs 14/9),average age [(64 ± 11) vs (64 ± 12)],lesion location (head/tail,7/13 vs 8/15] and TNM stage (Ⅲ/Ⅳ,9/11 vs 7/16),and the two groups were comparable.Compared with preoperative ones,the VAS score (3.0 points vs 5.5 points) and morphine dosage (30 mg vs 52.5 mg) were significantly lower in the CPN group one week after operation.In the CPR group,the VAS score (5.0 points vs 6.0 points) and morphine dosage (50 mg vs 55 mg) at 2 weeks after the operation were lower than those before the operation;the VAS scores of 4,8 and 12 weeks after the operation decreased to 3.0 points,and the dosage of morphine decreased to 30 mg,25 mg and 30 mg,respectively.The differences were statistically significant (P＜0.0001).Compared with the CPR group,at 2 weeks postoperatively the CPN group demonstrated a significantly higher decrease of VAS score (3.0 points vs 2.0 points),degree of morphine reduction (30 mg vs 10 mg) and rate of partial pain relief (70.0％ vs 4.3％).However,from 4 to 12 weeks postoperatively,the decrease in VAS score,the decrease in the dosage of MS Contin and the rate of partial pain relief in the CPR group were all significantly higher than those in the CPN group (P ＜ 0.05).There was no complete relief of pain in the two groups.No procedure-related deaths or serious complications were observed and only mild gastrointestinal adverse reactions occurred.Conclusions Two methods can both relieve abdominal pain in patients with advanced pancreatic cancer safely and effectively.CPR takes effect late but has advantages of good extent and long duration of pain relief.
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Objective To investigate the effect of needle sizes and aspiration techniques on sample quantity. Methods Aspiration was performed on porcine liver in vitro for 10 times with three different sizes of needles(19 G, 22 G and 25 G) and four different aspiration techniques[non?negative pressure(NP), 10 ml NP,20 ml NP and slow?pull], 20 mm in depth. A total of six aspirations were performed with each needle by the same aspiration technique. All the obtained specimens were fixed in formalin with the cell block method. The samples were evacuated according to our grading criteria. Results The mean±standard deviation(SD) score for 19 G,22 G, 25 G were 5?71±0?69,4?63±1?24, 3?79±1?84 respectively. The mean±SD score for methods non?NP,10 ml NP,20 ml NP and slow?pull were 4?72±1?53,4?56±1?46,4?72±1?50,4?83±1?76 respectively. The multi?analysis of variance results showed that there were statistical differences between different needles size( F=12?00,P<0?001) with 19 G being the best,followed by 22 G and the least specimen obtained by 25 G needle. There were no statistical differences among aspiration techniques ( F=0?128, P=0?943).The analysis showed that the thicker the needle was,the better sample quality was 19 G yielded to the highest quantity of specimens. The most specimens could be obtained with 19 G needle and non?NP, 22 G needle and 20 ml NP and 25 G needle and slow?pull. Conclusion In clinic, aspiration technique should be selected according to different aspiration needles. 19 G is superior to others, with non?NP method. For 22 G needle, 20 ml NP is preferred and for 25 G needle,slow?pull is preferred.
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Objective To investigate the risk factors for failure of percutaneous catheter drainage (PCD) for patients with infective pancreatic necrosis (IPN).Methods A retrospective review of medical records of patients with IPN who received PCD at Pancreatic Intensive Care Unit (PICU) of Changhai Hospital from April 2010 to June 2014 was performed.The patients were divided into 2 groups:(1) PCD success group (n =48) and (2) PCD failure group (n =12).The potential parameters for failure of PCD were recorded,which included age,sex,etiology,length of hospital stay,outcome,MCTSI,APACHE Ⅱ scores,number of organ failure,duration of use of antibiotics,duration of use of PPIs,if delayed fluid resuscitation occurred,start of enteral nutrition,nutrition status,etc,and univariate and multivariate logistic regression analysis was used.Results Univariate analysis showed MCTSI,number of organ failure,malnutrition,use of PPIs (more than two weeks),delayed enteral nutrition,delayed fluid resuscitation,the number of drainage catheter,number of aspiration,multi-drug resistant infections of drainage fluid were risk factors for failure of PCD;while multivariate logistic regression analysis showed that MCTSI (OR =3.33;95％ CI 1.52 ～ 7.29;P =0.003);multi-drug resistant infections of drainage fluid (OR =8.62;95 ％ CI 1.11 ～ 67.19;P =0.040) were risk factors for failure of PCD.Conclusions MCTSI and multi-drug resistant infections of drainage fluid can significantly influence the success rate of PCD.PCD should be carefully considered for patients with high score of MCTSI and multi-drug resistant infections of drainage fluid.
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Objective To investigate the features of PET-CT manifestation of pancreatic metastasis,and to improve its detection rate.Methods The PET-CT images of 31 cases of clinically diagnosed pancreatic metastases and 26 cases of primary pancreatic cancer were retrospectively evaluated.Two experienced specialists identified the lesion location in fused images.After frame by frame image analysis,the lesions with significantly increased radioactivity uptake were seen as positive,when compared with surrounding normal pancreatic tissue.The outline of regions of interest was drawn along the edge of the lesion shown in PET,and based on a semi-quantitative evaluation,the maximum standard uptake value (SUVmax) was calculated.If SUVmax ＞ 2.5,it was considered as positive.Results Among the 31 cases with pancreatic metastasis,22 cases of lung cancer,2 cases of gastric cancer 2 cases of colon carcinoma,1 case of maxillary sinus carcinoma,thyroid carcinoma,melanoma,renal cell carcinoma or gallbladder carcinoma were identified.Twenty-one cases (67.7％) were single,10 cases (32.3％) were multiple or diffuse lesions.Among the single lesions,7 (33.3％) were located in the pancreatic head and neck,14 in pancreatic body and tail.Among the 26 cases of primary pancreatic carcinoma,18 cases (69.2％) were located in the pancreatic head,8(30.8％) in the pancreatic body and tail.The sites of primary and metastatic pancreatic cancer were significantly different (x2 =6.012,P =0.014).CT scan showed only 17 nodular lesions with relatively low density and less clear boundary.PET images showed lesions in 31 cases of metastatic pancreatic cancer,and the mean SUVmax was 7.42 ± 3.48,which was significantly higher than that in primary pancreatic cancer group (5.39 ± 1.71,F =4.87,P =0.032).In addition,PET-CT identified 30 cases of other organs or lymph node metastasis.Conclusions PET-CT plays an important role in the diagnosis of metastatic pancreatic cancer.
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Objective To investigate the effects of different energy,frequency and time of holmium laser on the ablated porcine pancreas in vitro,and to establish an ablation regression equation of holmium laser,in order to provide the experiment foundation for EUS-guided holmium laser ablation of pancreatic carcinoma.Methods According to pilot study,the range of energy,frequency and time of holmium laser was determined,and five values were chosen for the individual three parameters,therefore,a randomize table including 125 combinations (sample capacity) according to the various combinations of every parameter was constructed,then every combination of holmium laser was used for porcine pancreas ablation in vitro.EUS was applied to determine the ablation site and measure the ablation extent,and pathological evaluation was performed.Results Sonographic images showed hyperechoic cloudy area in the ablation site.It was observed that the ablation body was an approximately oval area,the middle part was carbonized area,and the out layer was grey-white necrosis area.Microscopic examination showed there was pool-like cavity in the middle of ablation site,and it was surrounded by coagulation necrosis of pancreatic tissue,and the out layer was inflammatory cells infiltration.Normal pancreatic tissue was found in the margin.The energy,frequency and time of hoimium laser were positively associated with the ablation extent,and the frequency was the main factor,followed by time and energy.The difference was statistically significant (P＜O.O1).The best combination was 25 s,25 Hz,1.8 J.An ablation regression equation was created,which was In (ablation volume) =β0 + β1 × time + β2 × frequency + β3 × energy.Conclusions The holmium laser can produce obvious tissue necrosis in porcine pancreas in vitro; the established holmium laser ablation regression equation can be the guidance for clinical practice.
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Objective To evaluate the safety and efficacy of direct celiac ganglion irradiation with 125I seeds for pain relief secondary to advanced pancreatic carcinoma (PC).Methods This study enrolled 23 consecutive patients who had moderate to severe pain resulting from advanced PC.All patients underwent EUS-guided direct celiac ganglion irradiation with 125I seeds.Follow-up was conducted at least once weekly until death.Blood parameters,Visual Analog Scale (VAS) score,mean analgesic consumption,and complications were evaluated during follow-up.Results All patients successfully underwent implantation at one attempt.The mean number of seeds implanted in the celiac ganglion per patient was 4 (range 2-6).Immediately after the procedure,pain relief and analgesic consumption showed no significant changes compared with preoperative values.Six patients (26％) reported pain exacerbation.Two weeks later,the VAS score and mean analgesic consumption were significantly less than preoperative values.No procedure-related deaths or major complications occurred.Conclusion EUS-guided direct celiac ganglion irradiation with 125I seeds can reduce the VAS score and analgesic drug consumption in patients with unresectable PC.
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Objective To evaluate the safety and efficacy of therapeutic ERCP for patients above 90 years of age.Methods The data of 37 patients of above 90 years who underwent 42 ERCP procedures from January 2001 to December 2009 were studied retrospectively and compared with those of 152 matched patients ( 168 procedures) below 65 years old at a 1∶4 ratio for success rate and complications.Results The rate of complete success,partial success,and failure in observation group was 73.81％ (31/42),19.05％(8/42) and 2.38％ (1/42),respectively,which were similar (P ＞0.05) with those in control group,with complete success rate at 85.12％ ( 143/168),partial success rate at 12.50％ (21/168) and failure rate at 2.38％ (4/168).The rate of terminated operation in observation group (4.76％,2/42) was significantly higher than that of the control group (0.00％,0,P =0.039).The overall rate of complication in observation group was 7.14％ ( 3/42 ),slightly higher than that of the control group ( 6.55％,11/168,P ＞0.05 ).There was no significant difference between the two groups regarding the rates and severity of such complications as pancreatitis,hemorrhage and infection ( P ＞ 0.05 ).No perforation or death was observed.Conclusion Therapeutic ERCP for patients of 90 years or older is safe and effective.Adverse events related to chronic concomitant diseases need early detection and proper management.
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Objective To explore the feasibility of establishing porcine model for training of endoscopic ultrasound (EUS) guided celiac plexus paracentesis.Methods A total of 6 healthy pigs were sedated with an intramuscular injection of Ketamin at 10 mg/kg,followed by intravenous injection of 3% pentobarbital at 0.8 ml/kg.EUS was then performed and empty seeds were implanted into celiac plexus.Enhanced CT scan was performed to confirm the location of the implanted seeds.Results No animal died after the procedure.All seeds were accurately distributed on both sides of the celiac trunk except in one pig the seed was found in stomach by CT scan and was re-implanted another day.Conclusion Pigs are similar to human in anatomic structure and they can be excellent models for beginner endoscopy physicians to acquire the skill of EUS guided celiac plexus paracentesis.
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ObjectiveTo assess the safety of celiac plexus brachytherapy with 125Ⅰseeds placementguided by endoscopic ultrasound in porcine model, and to evaluate its effect on surrounding vessels and organs.MethodsFourteen pigs were randomly divided into 4 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n=4),0.4 mCi seeds in Group B (n=4),0.8 mCi seeds in Group C (n=4) and one lateral injection with 5 ml dehydrated alcohol,respectively.Abdominal X-ray,Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds in group A,B and C.Routine blood test,liver and renal function,serum amylase and CD4+/CD8+ratio were examined preoperatively and at the end of the follow-up in all groups.Animals were euthanized in batch to observe the position of the implanted seeds.Tissues and organs around the seeds were dissected for pathological examination.ResultsThe procedure succeeded in 12 pigs (85.7%)and failed in two others (1 in group A,and 1 in C) due to inappropriate position.Rescue procedures were performed on another day and succeeded.No significant difference was found in routine blood test,liver and renal func-tion,serum amylase and CD4+/CD8+ratio,except WBC elevation and small abcesses were found 7 days after the procedure in one pig of group C.In the radiated area, there was degeneration,necrosis and mild in-flammation at the outer membrane of blood vessels,with fibrosis around,which was positively correlated with the radiation dosage and duration.There was no change at the muscular layer and the innermost membrane of blood vessels,and no thrombosis was found.In group D,the celiac trunk became slightly brown and wider with obvious hemorrhage,necrosis and infiltration of inflammatory cells in the outer membrane of blood vessles and connective tissues around.ConclusionBrachytherapy has little negative effect on the organs a-round. It does not harm immunnity but induces lesions in blood vessels. Compared with dehydrated alcohol,this negative effect is limited.Therefore,celiac plexus brachytherapy with125Ⅰseeds guided by endoscopic ultrasound is safe.
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Objective To evaluate the influence of brachytherapy with 125Ⅰ seeds on celiac ganglia in porcine models. Methods Twelve pigs were randomly assigned into 3 groups to accept celiac plexus block by bilateral injection with 2 non-radioactive seeds in group A (n = 4), 0.4 mCi seeds in Group B (n = 4) and 0.8 mCi seeds in Group C (n = 4), respectively. Prophylactic antibiotics were administered postoperatively. Enhanced CT and three-dimensional reconstruction of blood vessels were performed to confirm the proper placement of the seeds. The animals were sacrificed 14 days and 60 days after the procedure, and TUNEL assay was employed to study neuron apoptosis in ediac ganglia. Results The procedure was succossfully performed in,10 pigs(83.3%)and failed in two others. The rescue procedure was performed on the day after and succeeded in both pigs. Apoptosis of neurons significantly increased in brachytherapy groups than in the control group and it was positively correlated with dose and time of radiation. Conclusion Brachytherapy can cause apoptosis of neurons of celiac ganglion, which could be the basis of its clinical application.
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Objective To assess the safety of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA)of pancreatic lesions.Methods Patients who underwent EUS-FNA of a pancreatic lesion between January 2005 and June 2007were studied retrospectively.Possible risk factors were assessed by using logistic analysis.Results In 119 patients who underwent pancreatic EUS-FNA,mild acute pancreatitis were observed in 1(0.84%)patient after the operation.No complication occurred in 12 patients with regional portal vein hypertension.Nine patients(7.6%)showed hyperamylasemia 3 h after the procedure,rangeing from 197 to 835 U/L,with an average of(327±200)U/L.Blood amylase level kept increasing 24 h postoperatively in 6 cases of the 9.Logistic regression analysis showed past history of acute pancreatitis,gender,needle size,number of puncture,cystic foci,preoperative blood amylase level and location of foci would not possibly be the risk factors of hyperamylasemia.Conclusion Incidence of complications after EUS-FNA is 0.84%,and the occurrence rate of hyperamylasemia is 7.6%,indicating,EUS-FNA is a safe procedure.