Department of Clinical and Experimental Medicine "Magrassi-Lanzara", Gastroenterology Unit, Second University of Naples, Naples, Italy.
Dig Liver Dis. 2013 Oct;45(10):816-9. doi: 10.1016/j.dld.2013.04.003. Epub 2013 May 24.
Endoscopical examination is not always sufficient for the diagnosis of gastrointestinal masses. This study assessed the diagnostic accuracy and safety of ultrasound-guided percutaneous biopsy of gastrointestinal lesions.
This retrospective study evaluated 114 patients who underwent ultrasound-guided biopsy of gastrointestinal masses with a 18G needle. Thirty-two of these patients underwent a 22G fine-needle biopsy for cytology. Histology was compared with a composite standard of reference for diagnosis (i.e. post-surgery histological evaluation in 73 cases and computed tomography or magnetic resonance scan findings, together with a compatible clinical follow-up for at least 24 months, in the remaining 41 cases). Safety was assessed by recording side effects for up to 4h after the procedure.
Of the 114 lesions evaluated, 112 were malignant (98.2%) and 2 benign (1.8%). Specimens were adequate for histology in all but one case. Specimens were obtained from the stomach (n=38; 33.3%), small bowel (n=36; 31.6%) and colon (n=40; 35.1%). Diagnosis was correct in 113/114 cases (99.1%). Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were 99.1%, 100%, 100%, 66%, and 99%, respectively. One of the 114 patients (0.9%) bled from a gastric GIST.
Ultrasound-guided percutaneous biopsy of gastrointestinal lesions is a valid alternative when diagnosis of a gastrointestinal mass cannot be obtained with an endoscopical procedure.
内镜检查并不总是足以诊断胃肠道肿块。本研究评估了超声引导下经皮胃 肠道病变活检的诊断准确性和安全性。
本回顾性研究评估了 114 例接受 18G 针超声引导下胃肠道肿块活检的患者。其中 32 例患者进行了 22G 细针活检细胞学检查。组织学与综合参考标准（即 73 例术后组织学评估和 41 例 CT 或磁共振扫描结果，以及至少 24 个月的临床随访）进行比较。安全性通过记录术后 4 小时内的不良反应来评估。
在评估的 114 个病变中，112 个为恶性（98.2%），2 个为良性（1.8%）。除 1 例外，所有病例均获得了足够的组织学标本。标本取自胃（n=38；33.3%）、小肠（n=36；31.6%）和结肠（n=40；35.1%）。114 例中 113 例（99.1%）诊断正确。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 99.1%、100%、100%、66%和 99%。114 例患者中有 1 例（0.9%）胃 GIST 出血。
当不能通过内镜检查获得胃肠道肿块的诊断时，超声引导下经皮胃肠道病变活检是一种有效的替代方法。
