The Third Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Department of Pathology, Kansai Medical University, Hirakata Hospital, Osaka, Japan.
Gastrointest Endosc. 2015;81(6):1457-62. doi: 10.1016/j.gie.2015.01.031. Epub 2015 Apr 9.
EUS-guided FNA (EUS-FNA) has been increasingly performed to obtain specimens for the pathological evaluation of patients with GI and pancreaticobiliary masses as well as lymphadenopathies of unknown origin. Photodynamic diagnosis by using 5-aminolebulinic acid (ALA) has been reported to be useful for enabling the visual differentiation between malignant and normal tissue in various cancers.
To evaluate the diagnostic accuracy of fluorescence cytology with ALA in EUS-FNA.
A prospective study.
A single center.
A total of 28 consecutive patients who underwent EUS-FNA for the pathological diagnosis of a pancreaticobiliary mass lesion or intra-abdominal lymphadenopathy of unknown origin.
Patients were orally administered ALA 3 to 6 hours before EUS-FNA. The sample was obtained via EUS-FNA for fluorescence cytology and conventional cytology. A single gastroenterologist performed the fluorescence cytology by using fluorescence microscopy after the procedure, independently of the conventional cytology by pathologists.
The accuracy of fluorescence cytology with ALA in the differentiation between benign and malignant lesions by comparing the results of fluorescence cytology with the final diagnosis.
Of the 28 patients included in the study, 22 were considered as having malignant lesions and 6 patients as having benign lesions. Fluorescence cytology could correctly discriminate between benign and malignant lesions in all patients. Therefore, both the sensitivity and specificity of fluorescence cytology were 100% in our study.
Fluorescence cytology was performed by only 1 gastroenterologist with a small number of patients.
Fluorescence cytology with ALA in EUS-FNA may be an effective and simple method for differentiating between benign and malignant lesions.
EUS 引导下细针穿刺（EUS-FNA）已越来越多地用于获取 GI 和胰腺胆道肿块以及不明来源的淋巴结病变的病理评估标本。据报道，使用 5-氨基乙酰丙酸（ALA）进行光动力诊断对于在各种癌症中使恶性和正常组织的可视化区分变得有用。
评估 EUS-FNA 中 ALA 荧光细胞学的诊断准确性。
前瞻性研究。
单一中心。
共 28 例连续患者，他们因胰腺胆道肿块病变或不明来源的腹腔内淋巴结病变而行 EUS-FNA 进行病理诊断。
患者在 EUS-FNA 前 3 至 6 小时口服 ALA。通过 EUS-FNA 获得样本，用于荧光细胞学和常规细胞学检查。一名胃肠病学家在手术后通过荧光显微镜进行荧光细胞学检查，独立于病理学家进行的常规细胞学检查。
通过将荧光细胞学检查结果与最终诊断进行比较，评估 ALA 荧光细胞学在鉴别良恶性病变方面的准确性。
在纳入研究的 28 例患者中，22 例被认为患有恶性病变，6 例患有良性病变。荧光细胞学可以正确区分所有患者的良性和恶性病变。因此，在我们的研究中，荧光细胞学的敏感性和特异性均为 100%。
荧光细胞学仅由 1 名胃肠病学家进行，且患者数量较少。
EUS-FNA 中的 ALA 荧光细胞学可能是一种有效且简单的方法，可用于区分良性和恶性病变。
