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一项针对内镜超声检查医师的扩展培训计划提高了胰腺内镜超声引导下细针穿刺活检的自我诊断准确性。

An expanded training program for endosonographers improved self-diagnosed accuracy of endoscopic ultrasound-guided fine-needle aspiration cytology of the pancreas.

作者信息

Harada Ryo, Kato Hironari, Fushimi Soichiro, Iwamuro Masaya, Inoue Hirofumi, Muro Shinichiro, Sakakihara Ichiro, Noma Yasuhiro, Yamamoto Naoki, Horiguchi Shigeru, Tsutsumi Koichiro, Okada Hiroyuki, Yamamoto Kazuhide

机构信息

Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences , Okayama , Japan.

出版信息

Scand J Gastroenterol. 2014 Sep;49(9):1119-23. doi: 10.3109/00365521.2014.915051. Epub 2014 Jun 4.

Abstract

OBJECTIVE

Rapid on-site evaluation (ROSE) of cytologic adequacy improves the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). However, on-site advice from a cytotechnologist or cytopathologist is not always available during EUS-FNA. To enhance endosonographers' ability to assess the adequacy of EUS-FNA specimens, we designed an intensive, 2-h interactive training program. The aim of this study was to determine the usefulness of the program.

METHODS

Four cytological pictures were selected by a trained cytotechnologist and board-certified cytopathologist from each of the seven patients who underwent EUS-FNA for pancreatic mass in Okayama University Hospital. In total, 28 pictures were used in this study. Twenty endosonographers and 14 cytologists with different levels of EUS-FNA experience evaluated cytological pictures independently before and after the training program.

RESULTS

Endosonographers' skill in evaluating the adequacy of EUS-FNA specimens was significantly improved after the completion of the training program (p < 0.001). In contrast, almost all cytologists correctly judged the adequacy of the specimens before taking the training program.

CONCLUSIONS

This intensive, 2-h interactive training program is useful for endosonographers and capable of improving ROSE of EUS-FNA specimens.

摘要

目的

对细胞学充分性进行快速现场评估(ROSE)可提高内镜超声引导下细针穿刺活检(EUS-FNA)的诊断率。然而,在EUS-FNA过程中,细胞技术人员或细胞病理学家的现场指导并非总是可得。为提高内镜超声检查医师评估EUS-FNA标本充分性的能力,我们设计了一个为期2小时的强化互动培训项目。本研究的目的是确定该项目的实用性。

方法

一名经过培训的细胞技术人员和一名获得委员会认证的细胞病理学家从冈山大学医院7例因胰腺肿块接受EUS-FNA的患者中,每人选取4张细胞学图片。本研究共使用了28张图片。20名内镜超声检查医师和14名具有不同EUS-FNA经验水平的细胞学家在培训项目前后分别独立评估细胞学图片。

结果

培训项目结束后,内镜超声检查医师评估EUS-FNA标本充分性的技能有显著提高(p<0.001)。相比之下,几乎所有细胞学家在参加培训项目之前就能正确判断标本的充分性。

结论

这个为期2小时的强化互动培训项目对内镜超声检查医师有用,并且能够提高EUS-FNA标本的ROSE。

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