Ribeiro A, Vazquez-Sequeiros E, Wiersema L M, Wang K K, Clain J E, Wiersema M J
Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology and Department of Surgical Pathology, Mayo Clinic, Rochester, MN 55905, USA.
Gastrointest Endosc. 2001 Apr;53(4):485-91. doi: 10.1067/mge.2001.112841.
Limited information is available regarding the use of EUS-guided fine-needle aspiration (EUS-FNA) in the diagnosis of lymphoproliferative disorders. The aim of this study was to evaluate the yield of this technique in the primary diagnosis of lymphoma.
The records were reviewed of 38 consecutive patients with GI lesions and/or enlarged lymph nodes identified on imaging studies that raised a suspicion of lymphoma who underwent EUS-FNA of lymph nodes or the gut wall. Final diagnosis was based on clinical follow-up, imaging studies, or surgical findings.
Twenty-three patients with lymphoma and 15 patients with benign disease or reactive lymphadenopathy were identified. The overall sensitivity, specificity, and accuracy of EUS-FNA cytology with flow cytometry/immunocytochemistry (FC/IC) for the diagnosis of lymphoma were, respectively, 74%, 93%, and 81%. When comparing patients who had EUS-FNA with FC/IC versus those who had EUS-FNA without FC/IC, sensitivity was 86% versus 44% (p = 0.04), specificity was 100% versus 90% (not significant), and accuracy was 89% versus 68% (not significant).
EUS-FNA can provide cytology specimens diagnostic for lymphoma. Selective use of FC/IC in patients with suspected lymphoma improves the yield of EUS-FNA and may guide diagnostic evaluation and treatment decisions.
关于超声内镜引导下细针穿刺抽吸术（EUS-FNA）在诊断淋巴增殖性疾病中的应用，目前可用信息有限。本研究的目的是评估该技术在淋巴瘤初步诊断中的诊断率。
回顾了连续38例经影像学检查发现胃肠道病变和/或淋巴结肿大、怀疑患有淋巴瘤并接受淋巴结或肠壁EUS-FNA检查的患者的记录。最终诊断基于临床随访、影像学检查或手术结果。
确定了23例淋巴瘤患者和15例良性疾病或反应性淋巴结病患者。EUS-FNA细胞学联合流式细胞术/免疫细胞化学（FC/IC）诊断淋巴瘤的总体敏感性、特异性和准确性分别为74%、93%和81%。比较接受EUS-FNA联合FC/IC检查的患者与仅接受EUS-FNA检查的患者，敏感性分别为86%和44%（p = 0.04），特异性分别为100%和90%（无显著性差异），准确性分别为89%和68%（无显著性差异）。
EUS-FNA可提供诊断淋巴瘤的细胞学标本。对疑似淋巴瘤患者选择性使用FC/IC可提高EUS-FNA的诊断率，并可能指导诊断评估和治疗决策。
