Lin Lien-Fu, Tung Jai-Nien
Division of Gastroenterology, Department of Internal Medicine, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, ROC.
Indian J Gastroenterol. 2008 Jul-Aug;27(4):156-8.
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was first reported in 1991 and 1992 for gastric submucosal tumor and pancreas cancer. Subsequently, the indications have expanded to mediastinal lesions, liver, spleen, adrenal gland, ascites, pleural effusion, intra-abdominal lymph nodes. We report our experience of EUS-FNA and the number of cases required during the learning curve. From May 2005 to December 2007, we did a retrospective analysis of 45 cases (median age: 68 [range] [37-87] years; 34 men and 11 women) of EUS-FNA punctures on solid masses. EUS-FNA was performed with linear echoendoscope (Olympus GF-UCT2000, EUC2000 unit) using 22 gauge needles (Olympus power-shot needle and Wilson Cook echo-tip needle). The procedure was done by a single endoscopist. Patients were divided into 2 groups, the first 30 patients (group A) and the last 15 patients (group B). The median size of tumor was 2.6 cm (range: 1-14 cm) in group A and 2 cm (range: 0.7-3.5 cm) in group B (p=0.023). The median number of punctures was the same in both groups, i.e. 2 (range: 1-4). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy in groups A and B were 55.1% vs. 85.7%, 100% vs. 100% 100% vs. 100%, 7.1% vs. 33.3%, 56.6% vs. 86.6% respectively. Group B patients had smaller tumor size, but with higher sensitivity and accuracy rates. Only one patient in group A needed 4 units of blood transfusion. EUS-FNA is a safe intervention; the sensitivity and accuracy rate can be improved after a learning curve of 30 cases.
内镜超声引导下细针穿刺活检（EUS-FNA）于1991年和1992年首次报道用于胃黏膜下肿瘤和胰腺癌。随后，其适应证已扩展至纵隔病变、肝脏、脾脏、肾上腺、腹水、胸腔积液、腹腔内淋巴结。我们报告了我们的EUS-FNA经验以及学习曲线期间所需的病例数。2005年5月至2007年12月，我们对45例（中位年龄：68岁[范围][37 - 87]岁；34例男性和11例女性）针对实性肿块的EUS-FNA穿刺进行了回顾性分析。EUS-FNA使用线性超声内镜（奥林巴斯GF-UCT2000，EUC2000主机）及22G穿刺针（奥林巴斯强力穿刺针和威尔逊·库克超声穿刺针）进行操作。该操作由一名内镜医师完成。患者分为两组，前30例患者（A组）和后15例患者（B组）。A组肿瘤的中位大小为2.6 cm（范围：1 - 14 cm），B组为2 cm（范围：0.7 - 3.5 cm）（p = 0.023）。两组的中位穿刺次数相同，均为2次（范围：1 - 4次）。A组和B组的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为55.1%对85.7%、100%对100%、100%对100%、7.1%对33.3%、56.6%对86.6%。B组患者的肿瘤较小，但敏感性和准确率较高。A组只有1例患者需要输注4个单位的血液。EUS-FNA是一种安全的干预措施；经过30例的学习曲线后，敏感性和准确率可以提高。
