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内镜超声引导下单切口针刀活检对胃黏膜下肿瘤的诊断效能:与手术切除标本的比较

Diagnostic yield of endoscopic ultrasonography-guided single-incision needle knife biopsy for gastric subepithelial tumors: comparison with resected specimens.

作者信息

Kim Joon Sung, Kim Byung-Wook, Kim Gi Jun, Kim Young Wook, Ryu Seung Ji, Park Sung Min, Ji Jeong-Seon, Jun Sun Young

机构信息

Division of Gastroenterology, Department of Internal Medicine, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, 56, Dongsu-ro, Bupyeong-gu, Incheon, 21431, Republic of Korea.

Department of Pathology, College of Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Republic of Korea.

出版信息

Surg Endosc. 2016 Dec;30(12):5304-5309. doi: 10.1007/s00464-016-4880-3. Epub 2016 Jun 28.

Abstract

BACKGROUND

Several techniques are recommended for the histologic diagnosis of gastric subepithelial tumors (SETs). The purpose of our study was to evaluate the diagnostic yield and safety of endoscopic ultrasonography-guided single-incision needle knife (SINK) biopsy for the diagnosis of gastric SETs.

METHODS

A retrospective review of patients who received biopsy for gastric SETs from August 2012 to May 2015 was conducted. Patients who received endoscopic ultrasonography and were found to have a SET originating from the muscularis propria of the stomach were included in the study. The aim of our study was to investigate the safety and diagnostic yield of SINK biopsy for gastric SETs.

RESULTS

A total of 31 patients received SINK biopsy for SETs. The diagnostic yield of SINK biopsy was 87 % (95 % CI 75-100 %), and the diagnostic accuracy was 89 % (95 % CI 74-105 %). The sensitivity of SINK biopsy to identify gastrointestinal stromal tumors was 83 % (95 % CI 52-98 %); the specificity was 100 % (95 % CI 59-100 %); the positive predictive value was 100 % (95 % CI 69-100 %); and the negative predictive value was 78 % (95 % CI 40-97 %). There were no procedure-related adverse events during and after procedure.

CONCLUSION

The use of SINK biopsy technique in patients with SETs is a good diagnostic tool with high diagnostic yield and accuracy. The method is simple, safe, and associated with few complications.

摘要

背景

推荐了几种用于胃黏膜下肿瘤(SETs)组织学诊断的技术。我们研究的目的是评估内镜超声引导下单切口针刀(SINK)活检对胃SETs诊断的取材成功率及安全性。

方法

对2012年8月至2015年5月期间接受胃SETs活检的患者进行回顾性研究。纳入接受内镜超声检查且发现有起源于胃固有肌层的SETs的患者。我们研究的目的是探讨SINK活检对胃SETs的安全性和取材成功率。

结果

共有31例患者接受了SETs的SINK活检。SINK活检的取材成功率为87%(95%可信区间75%-100%),诊断准确率为89%(95%可信区间74%-105%)。SINK活检识别胃肠道间质瘤的敏感性为83%(95%可信区间52%-98%);特异性为100%(95%可信区间59%-100%);阳性预测值为100%(95%可信区间69%-100%);阴性预测值为78%(95%可信区间40%-97%)。术中及术后均未发生与操作相关的不良事件。

结论

在SETs患者中使用SINK活检技术是一种取材成功率和准确性高的良好诊断工具。该方法简单、安全,并发症少。

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