超声内镜引导下细针穿刺在消化系占位性病变诊断中的价值

目的 探讨超声内镜引导下的细针穿刺检查(EUS-FNA)在消化系占位性病变诊断中的价值.方法 2007年5月-2008年12月对68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)病理学检查结果与术后病理结果及随访结果.结果 EUS-FNA细胞取材成功率91.18%(62/68).其中病灶位于食管4例(6.45%,4/62),胃19例(30.65%,19/62),直肠19例(30.65%,19/62),肝脏3例(4.84%,3/62),纵隔4例(6.45%,4/62),淋巴结13例(20.97%,13/62).40例患者细胞学检查结果阳性,阳性率为64.52%(40/62).22例患者获得组织碎片或细条行病理学检查,组织获得率为35.48%(22/62),其中10例病理学检查结果阳性,阳性率为45.45%(10/22).与术后病理结果及长期随访结果对照,EUS-FNA对消化系占位性病变诊断的准确率为85.48%.敏感度为90.91%,特异度为100.00%,阴性预测值为57.14%,阳性预测值为100.00%.结论 在消化系占位性病变诊断中,EUS-FNA是一项安全、有效、准确的诊断及鉴别诊断方法,在细胞学诊断中具有重要临床价值.

The role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of gastrointestinal tract lesions

Objective To assess the role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA)for diagnosis of gastrointestinal tract lesions.Methods Sixty-eight patients underwent endoscopic uhrasonagraphy and EUS-FNA between May 2007 and Dec.2008.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 62 patients with lesiorm in oesophagus(4 eases),stomach(19 case),rectum(19 cases),liver(3 case),mediastinum(4 cases)and lymph node(13 cases),and had a successful rate of 91.18%(62/68).Among them,the lesions in 40 patients(64.52%)were cytologically confirmed.The lesions in 10 out of 22 patients(35.48%)were pathologically confirmed.Compared with the results of pathology and long-term followe-up study,the sensitivity,specificity and positive predictive value of EUSFNA in diagnosis of lesions in gastrointestinal tract was 85.48%,100.00%and 90.91%,respectively,The positive predictive value and negative predictive value was100.00%and 57.14%,respectively.Conclusion EUS-FNA is a safe,effective and accurate method for diagnosis of lesions in gastrointestinal tract,and has an important role in cytological diagnosis.