目的 探讨内镜超声引导下细针穿刺抽吸术(EUS-FNA)对上消化道壁隆起性病变的诊断准确性及其临床应用价值。方法 对2011年11月-2013年12月间35例患者行超声内镜检查及超声内镜引导下的细针穿刺检查,对比细胞学和(或)病理学检查与术后病理结果及随访结果。结果 共35例患者成功进行了EUS-FNA,穿刺成功率100%。其中病灶位于食管4例(11.43%,4/35),胃26例(74.29%,26/35),十二指肠球部5例(14.28%,5/35)。29例患者细胞学检查结果阳性,阳性率为82.85%(29/35)。15例患者获得组织碎片或组织细条行病理学检查,组织获得率为42.86%(15/35),其中10例病理学检查结果阳性,阳性率为60.66%(10/15)。与术后病理结果及长期随访结果对照,EUS-FNA后细胞学和(或)病理学检查的诊断准确率为85.71%(30/35)。结论 在上消化道及周围实质性占位病变中,EUS-FNA是一项安全、有效、准确的诊断及鉴别诊断方法。
Objective To evaluate the accuracy and clinical application of endoscopic ultrasound
guided fine needle aspiration(EUS-FNA) in diagnosis of occupying lesions in upper digestive tract and its peripheral areas.Methods Forty-six patients underwent endoscopic ultrasonagraphy and EUS-FNA between November 2011 and December 2013.The result of cytology and/or pathology was compared with that of surgical finding and follow-up study.Results EUS-FNA was
successfully performed on 35patients,with a success rate of100%. The35patients with lesions in oesophagus (4 cases), stomach(26 cases), duodenalbulb(5 cases). Among them,the lesions in 29 patients (82.85%) were cytologically confirme.The lesions in10 out of15 patients (60.66%) were pathologically confirmed.Compared with the results of pathology and long-term followe-up study,the overall diagnostic accuracy of EUS-FNA in diagnosis of lesions in upper digestive tract and its peripheral areas was 85.71%(30/35). There were no complications during the procedures. Conclusion EUS-FNA is a safe, effective and accurate method for diagnosis of occupying lesions in upper digestive tract and its peripheral areas.
[1]Vilmann P, Jacobsen GK, Henriksen FW, et.Endoscopic utrasonography with guided fine needle aspiration biopsy in pancreatic disease[J].Gastrointest Endosc, 1992, 38(2):172-173
[2]Maluf-Filho F, Dotti CM, Halwan B, et a1.An evidence-based consensus statement on the role and application of endosonography in clinical practice[J].Endoscopy, 2009, 41(11):979-987
[3] Christian Jenssen, Maria Victoria, Alvarez-Sánch, et al.Diagnostic endoscopic ultrasonography: Assessment of safety and prevention of complications[J].World J Gastroenterol, 2012, 18(34):4659-4676
[4] Julio Iglesias-Garcia, Jose Lari?o-Noia, et, al.When to puncture, when not to puncture: Pancreatic masses[J].Endosc Ultrasound, 2014, 3(2):91-97
[5] Yoshinaga S, Suzuki H, Oda I, et, al.Role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosis of solid pancreatic masses[J].Dig Endosc, 2011, 23(5):29-33