Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Hellerup, Denmark.
Gastrointest Endosc. 2010 Mar;71(3):500-4. doi: 10.1016/j.gie.2009.10.044.
EUS is an integral part of the pretherapeutic evaluation program for patients with upper GI cancer.
To evaluate the impact of EUS-guided FNA on the clinical management of patients with gastric cancer.
The study included patients with confirmed gastric carcinoma who were referred to the Department of Surgical Gastroenterology, Gentofte Hospital, Copenhagen University, Copenhagen, Denmark, during a 6-year period (2001-2007).
The patients underwent standard pretherapeutic evaluation. If no signs of incurability were detected, the patients were offered EUS and EUS-guided FNA. EUS-guided FNA was performed when lymph nodes or lesions were considered to be distant metastases. A board of surgeons was asked to evaluate the management of the patients after the results obtained by EUS-guided FNA were revealed.
This study involved 234 patients with gastric carcinoma.
EUS-guided FNA.
Number of patients with distant metastasis diagnosed by EUS-guided FNA, with the avoidance of unnecessary surgery.
A total of 81 consecutive patients underwent EUS-guided FNA. Ninety-nine lesions were targeted, and 61 (62%) of these lesions were found to be malignant. In 38 of 81 patients (42%) distant metastases were confirmed by EUS-guided FNA. As judged by the board of surgeons, EUS-guided FNA changed the management plan in 34 of 234 patients (15%).
The positive EUS-guided FNA diagnoses were not surgically verified.
EUS-guided FNA is a very important modality and should be integrated as a routine procedure in the preoperative staging algorithm of gastric cancer.
EUS 是上消化道癌症患者治疗前评估计划的重要组成部分。
评估 EUS 引导下 FNA 对胃癌患者临床管理的影响。
本研究纳入了在丹麦哥本哈根大学 Gentofte 医院外科胃肠科就诊的经证实患有胃癌的患者，研究时间为 6 年（2001-2007 年）。
患者接受标准的治疗前评估。如果未发现不可治愈的迹象，将为患者提供 EUS 和 EUS 引导下 FNA。当怀疑淋巴结或病变为远处转移时，进行 EUS 引导下 FNA。EUS 引导下 FNA 结果揭晓后，将请外科医生委员会评估患者的管理。
本研究纳入了 234 例胃癌患者。
EUS 引导下 FNA。
通过 EUS 引导下 FNA 诊断的远处转移患者数量，避免不必要的手术。
共 81 例连续患者接受了 EUS 引导下 FNA。共靶向 99 个病灶，其中 61 个（62%）病灶为恶性。在 81 例患者中有 38 例（42%）通过 EUS 引导下 FNA 证实存在远处转移。根据外科医生委员会的判断，EUS 引导下 FNA 改变了 234 例患者中的 34 例（15%）的管理计划。
EUS 引导下 FNA 的阳性诊断未经过手术验证。
EUS 引导下 FNA 是一种非常重要的手段，应作为胃癌术前分期算法的常规程序进行整合。
