Endoscopic ultrasound-guided fine needle aspiration for gastrointestinal lesions with inconclusive endoscopic biopsies
10.3760/cma.j.issn.1007-5232.2019.05.009
- VernacularTitle:内镜超声引导下细针抽吸术在常规内镜活检诊断不明确的胃肠道病变中的应用价值
- Author:
Chunyan PENG
1
;
Hongzhen LI
;
Chengfei JIANG
;
Dehua TANG
;
Shanshan SHEN
;
Song ZHANG
;
Bo KONG
;
Lei WANG
;
Xiaoping ZOU
;
Ying LYU
Author Information
1. 南京大学医学院附属鼓楼医院消化内科
- Keywords:
Biopsy;
fine-needle;
Ultrasonography;
Endoscopy;
gastrointestinal;
Diagnosis
- From:
Chinese Journal of Digestive Endoscopy
2019;36(5):344-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the diagnostic value of endoscopic ultrasound-guided fine needle aspiration ( EUS-FNA ) for gastrointestinal lesions with inconclusive endoscopic biopsies. Methods A retrospective analysis was performed in 65 patients who were found to have gastrointestinal lesions with inconclusive endoscopic biopsies and underwent EUS-FNA in Drum Tower Hospital. Diagnostic value of EUS-FNA was determined by comparing with surgical histopathology and follow-up results. Results This study included 41 males ( 63％) and 24 females ( 37％) with median age of 60 years. The most common lesion was diffuse infiltrative lesions ( 37, 56. 9％) , followed by submucosal protrusion types ( 17, 26. 2％) . Fifty-four cases ( 83. 1％) were malignant lesions, and 11 cases ( 16. 9％) were benign. The overall sensitivity, specificity, and accuracy of EUS-FNA for gastrointestinal lesions with inconclusive biopsies were 76. 8％ ( 95％CI: 65. 7％-87. 8％) , 100. 0％ ( 95％CI: 66. 4％-100. 0％) , and 80. 0％( 95％CI: 70. 3％-89. 7％) , respectively. Sub-group analysis showed the sensitivity, specificity, and accuracy of EUS-FNA for diffuse infiltrative lesions were 70. 6％ ( 95％CI: 55. 3％-85. 9％, 100. 0％( 95％CI:29. 2％-100. 0％) , and 73. 0％ ( 95％CI: 58. 7％-87. 3％) , respectively. For submucosal protrusions, the sensitivity, specificity, and accuracy of EUS-FNA were 68. 8％ ( 95％CI: 46. 0％ -91. 5％) , 100. 0％ ( 95％CI: 2. 5％-100. 0％) , and 70. 6％ ( 95％CI: 44. 0％-89. 7％) , respectively. Conclusion EUS-FNA has moderate diagnostic value for endoscopic biopsy-inconclusive gastrointestinal lesions. It can be an alternative option when standard methods, such as endoscopic mucosal forceps biopsy, fail to provide a definitive diagnosis.
