Arantes Vitor, Logroño Roberto, Faruqi Sohaib, Ahmed Ijaz, Waxman Irving, Bhutani Manoop S
Center for Endoscopic Ultrasound, Department of Medicine, University of Texas Medical Branch, Galveston 77555-0764, USA.
J Ultrasound Med. 2004 Sep;23(9):1141-50. doi: 10.7863/jum.2004.23.9.1141.
To study the yield of endoscopic ultrasonographically guided fine-needle aspiration cytologic examination in the diagnosis of submucosal masses.
From 1999 to 2003, 10 patients underwent ultrasonographically guided fine-needle aspiration for the cytologic diagnosis of submucosal masses in our institution. The endoscopic ultrasonography records and the cytology database were consulted, and the reports were analyzed, as were slide material and the technical aspects related to these procedures. All procedures were performed under conscious sedation and cardiorespiratory monitoring on an outpatient basis. Ten patients (4 men and 6 women; mean age, 60.8 years) were studied.
Eight lesions were located in the stomach, and 2 were located in the esophagus, with a mean diameter of 3.3 cm. An experienced cytopathologist was present on-site during all procedures for assessment of adequacy and preliminary cytologic examination. Cytologic diagnoses were obtained in 8 cases as follows: 6 gastrointestinal stromal tumors, 1 organizing submucosal hematoma, and 1 low-grade mucosa-associated lymphoid tissue-associated lymphoma. Two cases consisted of scant gastric epithelium only and were considered nondiagnostic. The cytologic diagnoses guided further clinical treatment.
Ultrasonographically guided fine-needle aspiration with cytopathologic analysis has a high accuracy rate (80%) for diagnosing submucosal lesions. These findings potentially affect clinical decision making.
研究内镜超声引导下细针穿刺细胞学检查在诊断黏膜下肿块中的应用效果。
1999年至2003年，我院对10例患者进行了超声引导下细针穿刺，以对黏膜下肿块进行细胞学诊断。查阅了内镜超声记录和细胞学数据库，并对报告、载玻片材料以及与这些操作相关的技术方面进行了分析。所有操作均在门诊患者清醒镇静及心肺监测下进行。共研究了10例患者（4例男性，6例女性；平均年龄60.8岁）。
8个病变位于胃，2个位于食管，平均直径3.3 cm。在所有操作过程中均有经验丰富的细胞病理学家现场评估取材是否充分并进行初步细胞学检查。8例获得了细胞学诊断，结果如下：6例为胃肠道间质瘤，1例为组织化黏膜下血肿，1例为低度黏膜相关淋巴组织淋巴瘤。2例仅见少量胃上皮细胞，被认为无法诊断。细胞学诊断为进一步的临床治疗提供了指导。
超声引导下细针穿刺联合细胞病理分析对诊断黏膜下病变具有较高的准确率（80%）。这些结果可能会影响临床决策。
