Aithal Guruprasad P, Anagnostopoulos George K, Kaye Philip
Division of Gastroenterology and Pathology, Queen's Medical Centre University Hospital, Nottingham, United Kingdom.
Gastrointest Endosc. 2005 Oct;62(4):624-9. doi: 10.1016/j.gie.2005.06.013.
In patients with thickened esophagogastric wall on CT but without evidence of malignancy on endoscopic mucosal biopsies, obtaining adequate histology from the gut wall is difficult. We examined whether it is feasible to obtain diagnostic tissue core from the gut wall by using EUS-guided Trucut biopsy technique in this group of patients.
Ten patients were included in this study. Under EUS guidance, mucosa was penetrated by using a 19-gauge Trucut needle, and a 18-mm tissue tray was advanced obliquely through the wall layers to avoid penetration of the serosa. Then, the cutting sheath was fired over the tray.
Biopsies were performed without complications. Diagnoses of carcinoma were made in 5 patients. Four other patients had benign histology, and, during follow-up, all these diagnoses have been proven to be true negatives. One Trucut biopsy specimen was considered false negative.
The EUS-guided Trucut mural biopsy technique could yield diagnostic tissue cores in patients with unexplained thickening of the esophagogastric wall.
对于CT显示食管胃壁增厚但内镜黏膜活检未发现恶性证据的患者，从肠壁获取足够的组织学样本很困难。我们研究了在这类患者中使用超声内镜引导下Trucut活检技术从肠壁获取诊断性组织芯是否可行。
本研究纳入10例患者。在超声内镜引导下，使用19G Trucut针穿透黏膜，将一个18mm的组织槽斜向推进穿过各壁层以避免穿透浆膜。然后，在组织槽上发射切割鞘。
活检未发生并发症。5例患者诊断为癌。另外4例患者组织学为良性，在随访期间，所有这些诊断均被证实为真阴性。1例Trucut活检标本被认为是假阴性。
超声内镜引导下Trucut壁层活检技术可为食管胃壁不明原因增厚的患者获取诊断性组织芯。
