Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Gastrointest Endosc. 2011 Sep;74(3):504-10. doi: 10.1016/j.gie.2011.05.014.
The ability to obtain tissue samples for histological examination during EUS has theoretical advantages over cytology alone.
To prospectively evaluate the feasibility and yield of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle in patients in whom we expected histology to be more useful than cytology to reach a definitive diagnosis.
Prospective cohort study.
Tertiary care academic medical center.
Consecutive patients with subepithelial lesions, esophagogastric wall thickening, mediastinal and abdominal masses/lymphadenopathy of unknown origin, or pancreatic lesions after nondiagnostic FNA.
EUS-FNTA with a 19-gauge needle.
Feasibility and yield of EUS-FNTA.
A total of 120 patients with a mean age of 61 ± 14.6 years and mean lesion size of 38 ± 25 mm (range 8-140 mm) were enrolled. FNTA was successfully performed in all but 1 patient (98.9%), and adequate samples for histological examination were obtained in 116 of the 119 patients (97.5%) in whom EUS-FNTA was technically successful. A mean of 2.8 ± 0.8 passes per patient were performed. At the time of current follow-up, a definitive diagnosis was available in 117 of the 120 patients (97.5%), with only 8 false-negative results. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of EUS-FNTA in the 117 patients with a definitive diagnosis were 91.8%, 100%, 100%, 71.4%, and 93.2%, respectively.
Single-center study with limited power.
EUS-FNTA by using a large-gauge needle has a high yield and promising diagnostic accuracy and could be used when histology may be more useful than cytology to reach a definitive diagnosis.
相较于单独细胞学检查，EUS 下获取组织样本进行组织学检查具有理论优势。
前瞻性评估在我们认为组织学比细胞学更有助于明确诊断的患者中，使用大口径针进行 EUS 引导下细针组织采集（EUS-FNTA）的可行性和取材量。
前瞻性队列研究。
三级学术医疗中心。
上皮下病变、食管胃壁增厚、纵隔和腹部肿块/淋巴结肿大原因不明、或非诊断性 FNA 后胰腺病变的连续患者。
EUS-FNTA 使用 19 号针。
EUS-FNTA 的可行性和取材量。
共纳入 120 例患者，平均年龄 61±14.6 岁，平均病变大小 38±25mm（范围 8-140mm）。除 1 例（98.9%）患者外，其余患者均成功进行 FNTA，119 例技术上成功的患者中 116 例（97.5%）获得了足够用于组织学检查的样本。平均每位患者进行 2.8±0.8 次穿刺。在当前随访时，120 例患者中有 117 例（97.5%）获得了明确诊断，仅 8 例为假阴性结果。在 117 例有明确诊断的患者中，EUS-FNTA 的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为 91.8%、100%、100%、71.4%和 93.2%。
单中心研究，效能有限。
使用大口径针进行 EUS-FNTA 具有较高的取材量和有前景的诊断准确性，可用于组织学比细胞学更有助于明确诊断的情况。
Zotero 插件