O'Connor Kate, Cheriyan Danny G, Li-Chang Hector H, Kalloger Steven E, Garrett John, Byrne Michael F, Weiss Alan A, Donnellan Fergal, Schaeffer David F
Division of Anatomic Pathology, Vancouver General Hospital, Vancouver, B.C., Canada.
Acta Cytol. 2015;59(4):305-10. doi: 10.1159/000439398. Epub 2015 Sep 5.
Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is the preferred method for biopsying the gastrointestinal tract, and rapid on-site cytological evaluation is considered standard practice. Our institution does not perform on-site evaluation; this study analyzes our overall diagnostic yield, accuracy, and incidence of nondiagnostic cases to determine the validity of this strategy.
Data encompassing clinical information, procedural records, and cytological assessment were analyzed for gastrointestinal EUS-FNA procedures (n = 85) performed at Vancouver General Hospital from January 2012 to January 2013. We compared our results with those of studies that had on-site evaluation and studies that did not have on-site evaluation.
Eighty-five biopsies were performed in 78 patients, from sites that included the pancreas, the stomach, the duodenum, lymph nodes, and retroperitoneal masses. Malignancies were diagnosed in 45 (53%) biopsies, while 24 (29%) encompassed benign entities. Suspicious and atypical results were recorded in 8 (9%) and 6 (7%) cases, respectively. Only 2 (2%) cases received a cytological diagnosis of 'nondiagnostic'. Our overall accuracy was 72%, our diagnostic yield was 98%, and our nondiagnostic rate was 2%. Our results did not significantly differ from those of studies that did have on-site evaluation.
Our study highlights that adequate diagnostic accuracy can be achieved without on-site evaluation.
内镜超声引导下细针穿刺活检（EUS-FNA）是胃肠道活检的首选方法，快速现场细胞学评估被视为标准操作。我们机构不进行现场评估；本研究分析了我们的总体诊断率、准确性和非诊断性病例的发生率，以确定该策略的有效性。
分析了2012年1月至2013年1月在温哥华总医院进行的胃肠道EUS-FNA手术（n = 85）的临床信息、手术记录和细胞学评估数据。我们将我们的结果与有现场评估的研究和没有现场评估的研究结果进行了比较。
对78例患者进行了85次活检，活检部位包括胰腺、胃、十二指肠、淋巴结和腹膜后肿块。45例（53%）活检诊断为恶性肿瘤，24例（29%）为良性病变。分别有8例（9%）和6例（7%）记录为可疑和非典型结果。只有2例（2%）病例细胞学诊断为“非诊断性”。我们的总体准确率为72%，诊断率为98%，非诊断率为2%。我们的结果与有现场评估的研究结果没有显著差异。
我们的研究强调，不进行现场评估也能获得足够的诊断准确性。
