Department of Gastroenterology, Rambam Health Care Campus, Bat Galim, Haifa, Israel.
BMC Gastroenterol. 2011 Nov 2;11:117. doi: 10.1186/1471-230X-11-117.
EUS-guided FNA can help diagnose and differentiate between various pancreatic and other lesions.The aim of this study was to compare approaches among involved/relevant physicians to the controversies surrounding the use of FNA in EUS.
A five-case survey was developed, piloted, and validated. It was collected from a total of 101 physicians, who were all either gastroenterologists (GIs), surgeons or oncologists. The survey compared the management strategies chosen by members of these relevant disciplines regarding EUS-guided FNA.
For CT operable T2NOM0 pancreatic tumors the research demonstrated variance as to whether to undertake EUS-guided FNA, at p < 0.05. For inoperable pancreatic tumors 66.7% of oncologists, 62.2% of surgeons and 79.1% of GIs opted for FNA (p < 0.05). For cystic pancreatic lesions, oncologists were more likely to send patients to surgery without FNA. For stable simple pancreatic cysts (23 mm), most physicians (66.67%) did not recommend FNA. For a submucosal gastric 19 mm lesion, 63.2% of surgeons recommended FNA, vs. 90.0% of oncologists (p < 0.05).
Controversies as to ideal application of EUS-FNA persist. Optimal guidelines should reflect the needs and concerns of the multidisciplinary team who treat patients who need EUS-FNA. Multi-specialty meetings assembled to manage patients with these disorders may be enlightening and may help develop consensus.
EUS 引导下的 FNA 有助于诊断和区分各种胰腺和其他病变。本研究旨在比较相关医生在 EUS 中使用 FNA 的争议方面的方法。
开发了一个五例调查，进行了试点和验证。它收集了总共 101 名医生的信息，他们都是胃肠病学家（GI）、外科医生或肿瘤学家。该调查比较了这些相关学科的成员在 EUS 引导下 FNA 方面选择的管理策略。
对于 CT 可操作的 T2NOM0 胰腺肿瘤，研究表明，在是否进行 EUS 引导下 FNA 方面存在差异，p < 0.05。对于不可手术的胰腺肿瘤，66.7%的肿瘤学家、62.2%的外科医生和 79.1%的 GI 选择进行 FNA（p < 0.05）。对于囊性胰腺病变，肿瘤学家更倾向于在不进行 FNA 的情况下将患者转至手术。对于稳定的单纯性胰腺囊肿（23mm），大多数医生（66.67%）不建议进行 FNA。对于一个 19mm 的黏膜下胃病变，63.2%的外科医生建议进行 FNA，而 90.0%的肿瘤学家建议进行 FNA（p < 0.05）。
对于 EUS-FNA 的理想应用仍然存在争议。最佳指南应反映需要和关注的多学科团队，他们治疗需要 EUS-FNA 的患者。为管理这些疾病的患者而组建的多专业会议可能会有启发性，并有助于达成共识。
