Endoscopic ultrasound-guided fine needle aspiration for diagnosis of lesions of gastrointestinal tract and adjacent organs
10.3760/cma.j.issn.1007-5232.2011.09.006
- VernacularTitle:内镜超声引导下细针穿刺活检术在消化道管壁及其周围器官疾病诊断中的应用价值
- Author:
Xiangwu DING
- Publication Type:Journal Article
- Keywords:
Endoscopic ultrasonography;
Neoplasma;
Fine-needle aspiration
- From:
Chinese Journal of Digestive Endoscopy
2011;28(9):497-501
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for diagnosing lesions of gastrointestinal tract and the nearby organs. MethodsClinical and pathological data of 161 EUS-FNA lesions in 133 consecutive patients were retrospectively analyzed. ResultsOf the 161 lesions, there were 142 solid lesions, 15 cystic lesions and 4 pancreatic solid-cystic lesions. EUS-FNA was performed at lesions of upper gastrointestinal tract, rectum and anal canal. 160 cytologic diagnoses (99. 4％ ) were obtained in all 161 lesions. 143 histological diagnoses (97.9％) and 113 immunohistological diagnoses (77.4％) were obtained in 146 solid lesions (including 4 pancreatic solid-cystic ones). Diagnosis rates of samples for immunohistology remained similar between 22-gauge and 19-gauge needles and also similar among different sites (P ＞ 0. 05). But immunohistological diagnosis rate of smaller lesions ( ＜ 1 cm) was lower than that of bigger ones ( ≥ 1 cm) ( P ＜ 0. 05). The diagnosis rates of cytology,histology and pathology in solid lesions were 81.2％ ( 120/146), 82. 9％ (121/146) and 89. 7％ ( 131/146), respectively. Size of needles and lesion location did not exert influence on diagnosis, but the diagnosis rate of smaller lesions ( ＜ 1 cm) was lower than that of bigger ones ( ≥ 1 cm). Cytological diagnosis was consistent with histological diagnosis ( k =1. 0, P =0. 00), 11 cases that could not be diagnosed by cytology was confirmed by histology and 10 cases that could not diagnosed by histology was confirmed by cytology.There were no complications during the procedures. ConclusionEUS-FNA is a valuable diagnostic tool for lesions of gastrointestinal tract and nearby organs. The needle size and lesion site were not influential factors for diagnosis. Smaller lesions ( ＜ 1 cm) yielded lower diagnosis rate than bigger ones ( ≥ 1 cm). The cytologic diagnosis combined with histology can improve the diagnostic value of EUS-FNA.
