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内镜超声引导下活检中细针穿刺与细针毛细管采样对标本质量和诊断准确性的评估。

Evaluation of fine needle aspiration vs. fine needle capillary sampling on specimen quality and diagnostic accuracy in endoscopic ultrasound-guided biopsy.

作者信息

Storch Ian Michael, Sussman Daniel Andrew, Jorda Merce, Ribeiro Afonso

机构信息

Division of Gastroenterology, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Leonard Miller School of Medicine, Miami, Florida 33101, USA.

出版信息

Acta Cytol. 2007 Nov-Dec;51(6):837-42. doi: 10.1159/000325857.

Abstract

OBJECTIVE

To compare percutaneous and endoscopic ultrasound (EUS)-guided biopsy techniques.

STUDY DESIGN

From July 2005 to February 2006, all patients referred for EUS-guided fine needle aspiration (FNA) were considered. If inclusion criteria were met, the first 2 biopsy passes were performed without suction (fine needle capillary [FNC] sampling). Two additional passes were performed using the same needle with 10 mL of applied suction (FNA). A single blinded pathologist later retrospectively evaluated each set of slides. Fifty-three patients met inclusion criteria. The study group comprised pancreatic masses (23), lymph nodes (26), subepithelial masses (3) and liver lesion (1). There were 38 malignant and 15 benign lesions.

RESULTS

No statistically significant differences were found with the scoring systems considered in the study. In the subgroups of patients with pancreatic masses, lymph nodes, benign disease and malignant disease, no statistically significant outcomes were noted.

CONCLUSIONS

No difference exists between quality and diagnostic accuracy of specimens obtained from EUS-guided tissue acquisition via FNC and FNA. The decision to use FNC or FNA should be left to the discretion of the individual endosonographer.

摘要

目的

比较经皮和内镜超声(EUS)引导下的活检技术。

研究设计

2005年7月至2006年2月,纳入所有接受EUS引导下细针穿刺抽吸(FNA)的患者。若符合纳入标准,则在前两次活检进针时不进行抽吸(细针毛细采样[FNC])。再使用同一根针进行另外两次进针,并施加10 mL抽吸(FNA)。之后由一名单盲病理学家对每组玻片进行回顾性评估。53例患者符合纳入标准。研究组包括胰腺肿块(23例)、淋巴结(26例)、上皮下肿块(3例)和肝脏病变(1例)。其中有38例恶性病变和15例良性病变。

结果

研究中所采用的评分系统未发现有统计学显著差异。在胰腺肿块、淋巴结、良性疾病和恶性疾病患者亚组中,未观察到有统计学显著意义的结果。

结论

通过FNC和FNA进行EUS引导下组织采集所获得标本的质量和诊断准确性之间没有差异。使用FNC或FNA的决定应由内镜超声医师个人自行斟酌。

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