Fernández-Esparrach Gloria, Alberghina Nadia, Subtil José Carlos, Vázquez-Sequeiros Enrique, Florio Vivian, Zozaya Francisco, Araujo Isis, Ginès Angels
1 Endoscopy Unit, Gastroenterology Department, Institut Clínic de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERehd, University of Barcelona, Barcelona, Spain 2 Endoscopy Unit, Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Spain 3 Endoscopy Unit, Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
Dis Colon Rectum. 2015 May;58(5):469-73. doi: 10.1097/DCR.0000000000000329.
Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of malignancies surrounding the gastrointestinal tract. There is a lack of information on the usefulness of this technique in the diagnosis of colorectal cancer recurrence.
The purpose of this work was to investigate the performance characteristics of endoscopic ultrasound-guided fine needle aspiration for the cytologic diagnosis of perirectal recurrence of colorectal cancer.
This was a retrospective study on the clinical and radiologic suspicion of perirectal recurrence of colorectal cancer.
The study was conducted at 4 tertiary hospitals.
Consecutive patients with suspicion of perirectal recurrence of colorectal cancer undergoing endoscopic ultrasound-guided fine needle aspiration between 2000 and 2013 were included in this study.
The study intervention was endoscopic ultrasound-guided fine needle aspiration.
Endoscopic ultrasound-guided fine needle aspiration performance characteristics and outcome (malignant or benign) were analyzed. The gold standard was cytologic results if malignancy or follow-up if benignity.
A total of 58 patients were included (32 men; mean age, 64.2 ± 10.0 years [range, 44-88 years]). The location of the initial neoplasm was the rectum for 42 patients and the colon for 16 patients. Endoscopic ultrasound findings included a mass in the anastomosis (n = 8), perirectal fat (n = 23), lymph nodes (n = 20), or asymmetric thickness of the rectal wall (n = 6). Cytology showed malignancy in 38 patients (67%), benign features in 17 (30%), and was not evaluable in 2. Mean follow-up to confirm a benign outcome was 51.3 ± 30.3 months (range, 5.2-180.0 months). Final outcome was recurrence in 40 patients (69%) and benignity in 18 patients (31%). Performance characteristics of endoscopic ultrasound-guided fine needle aspiration were sensitivity (97%), specificity (100%), positive predictive value (100%), negative predictive value (94%), and accuracy (98%). In the intention to diagnose analysis, the corresponding values were 95%, 100%, 100%, 90%, and 96%.
This was a retrospective series with a limited number of patients.
Endoscopic ultrasound-guided fine needle aspiration is a highly accurate tool for the cytologic diagnosis of perirectal recurrence in patients with previous colorectal cancer.
内镜超声引导下细针穿刺抽吸术对胃肠道周围恶性肿瘤的诊断具有高度准确性。目前缺乏关于该技术在结直肠癌复发诊断中实用性的信息。
本研究旨在探讨内镜超声引导下细针穿刺抽吸术对结直肠癌直肠周围复发进行细胞学诊断的性能特征。
这是一项关于结直肠癌直肠周围复发的临床和影像学怀疑的回顾性研究。
该研究在4家三级医院进行。
纳入2000年至2013年间连续接受内镜超声引导下细针穿刺抽吸术且怀疑结直肠癌直肠周围复发的患者。
研究干预措施为内镜超声引导下细针穿刺抽吸术。
分析内镜超声引导下细针穿刺抽吸术的性能特征及结果（恶性或良性）。金标准为若为恶性则是细胞学结果，若为良性则是随访结果。
共纳入58例患者（32例男性；平均年龄64.2±10.0岁[范围44 - 88岁]）。初始肿瘤位于直肠的有42例患者，位于结肠的有16例患者。内镜超声检查结果包括吻合口肿物（n = 8）、直肠周围脂肪（n = 23）、淋巴结（n = 20）或直肠壁不对称增厚（n = 6）。细胞学检查显示38例患者为恶性（67%），17例为良性特征（30%），2例无法评估。确认良性结果的平均随访时间为51.3±30.3个月（范围5.2 - 180.0个月）。最终结果为40例患者复发（69%），18例患者为良性（31%）。内镜超声引导下细针穿刺抽吸术的性能特征为敏感性（97%）、特异性（100%）、阳性预测值（100%）、阴性预测值（94%）和准确性（98%）。在意向性诊断分析中，相应的值分别为95%、100%、100%、90%和96%。
这是一项患者数量有限的回顾性系列研究。
内镜超声引导下细针穿刺抽吸术是诊断既往结直肠癌患者直肠周围复发的一种高度准确的工具。
