目的:探讨经培训内镜医师实施快速现场评估(rapid on-site evaluation by endoscopic physicians themselves, self-ROSE)在胰腺实性占位内镜超声引导下细针抽吸术(endoscopic ultrasound-guided-fine needle aspiration, EUS-FNA)中的应用价值。方法:回顾性分析2017年1—12月在南京鼓楼医院接受EUS-FNA的连续124例胰腺实性占位患者的临床资料。2017年7—12月的病例行self-ROSE，纳入self-ROSE组(60例)；2017年1月—2017年6月的病例未行self-ROSE，纳入非self-ROSE组(64例)。比较self-ROSE组与非self-ROSE组患者EUS-FNA的诊断效能(灵敏度、特异度、阳性预测值、阴性预测值和准确率)、穿刺次数及并发症发生率等指标。结果:self-ROSE组的EUS-FNA诊断灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为98.21%(55/56)、4/4、100.00%(55/55)、4/5和98.33%(59/60)，而非self-ROSE组的EUS-FNA诊断灵敏度、特异度、阳性预测值、阴性预测值、准确率分别为81.82%(45/55)、9/9、100.00%(45/45)、47.37%(9/19)和84.38%(54/64)。self-ROSE组EUS-FNA的灵敏度(n P＝0.004)和准确率(n P＝0.009)均显著高于非self-ROSE组。在样本满意程度评估(n Kappa＝1.000，n P<0.05)和细胞病理学评估(n Kappa＝0.815，n P0.05]。2组均无并发症发生。n 结论:self-ROSE有助于提升胰腺实性占位EUS-FNA的诊断效能，可作为提高EUS-FNA诊断准确率的重要策略。“,”Objective:To analyze the application value of rapid on-site evaluation by endoscopic physicians themselves (self-ROSE)of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for solid pancreatic lesions.Methods:Data of 124 consecutive patients who underwent EUS-FNA for solid pancreatic lesions from January 2017 to December 2017 in Nanjing Drum Tower Hospital were retrospectively analyzed. The patients were divided into self-ROSE group (n=60, patients who received self-ROSE from July to December in 2017) and non-self-ROSE group (n=64, patients who didn’t receive self-ROSE from January to June in 2017). Diagnostic efficiency including sensitivity, specificity, positive predictive value, negative predictive value and accuracy, the number of punctures and complication incidence of EUS-FNA in self-ROSE group and non-self-ROSE group was compared.Results:The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA were 98.21% (55/56), 4/4, 100.00% (55/55), 4/5 and 98.33% (59/60), respectively in self-ROSE group. While in non-self-ROSE group, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 81.82% (45/55), 9/9, 100.00% (45/45), 47.37% (9/19) and 84.38% (54/64), respectively. The sensitivity (n P=0.004) and accuracy (n P=0.009) were both significantly higher during EUS-FNA in self-ROSE group than those in non-self-ROSE group. There was a high degree of consistency between endoscopists and pathologists in the evaluation of sample satisfaction (n Kappa=1.000, n P<0.05) and cytopathological diagnosis (n Kappa=0.815, n P0.05). No complication occurred in either group.n Conclusion:Self-ROSE is valuable for EUS-FNA in the diagnosis of solid pancreatic lesions, which could be an important strategy to increase the accuracy of EUS-FNA.