内镜超声引导下细针穿刺可针对右肝肿块。
Endoscopic ultrasound-guided fine-needle aspiration can target right liver mass.
作者信息
Oh Dongwook, Seo Dong-Wan, Hong Seung-Mo, Song Tae Jun, Park Do Hyun, Lee Sang Soo, Lee Sung Koo, Kim Myung-Hwan
机构信息
Department of Gastroenterology, Nowon Eulji Medical Center, Eulji University, South Korea.
Department of Gastroenterology, Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
出版信息
Endosc Ultrasound. 2017 Mar-Apr;6(2):109-115. doi: 10.4103/2303-9027.204813.
BACKGROUND AND OBJECTIVES
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been established as a safe and accurate method for diagnosing and staging intra-abdominal mass. However, few studies investigated its feasibility, efficacy, and safety for targeting liver mass. We evaluated the efficacy and safety of EUS-FNA in patients with liver masses including the right lobe.
PATIENTS AND METHODS
The technical feasibility, safety, and diagnostic yield were determined in 47 patients (30 in the left lobe and 17 in the right lobe) presenting with liver masses between September 2010 and February 2016.
RESULTS
Thirty-eight patients (80.9%) had malignancies whereas nine patients (19.1%) had benign liver masses. Technical success rate was 97.9% (46/47). EUS-FNA was diagnostic in 38 of 42 patients (90.5%). When the outcomes of EUS-FNA between right liver mass and left mass were accessed, the technical success rates were similar in both lobes (100% vs. 94.1%, P= 0.2). The median tumor size on EUS (25.5 mm, interquartile range [IQR] 13.8-30.3 vs. 28 mm, IQR 18.5-43.5, P= 0.24) and number of needle passes (3, IQR 3-4 vs. 3, IQR 3-3, P= 0.24) were not significantly different. Adequate specimen obtained was statistically higher in the left lobe (28/30, 93.3% vs. 14/17, 82.4%, P= 0.04). However, diagnostic accuracy for liver masses was not different (25/28, 89.3% vs. 13/14, 92.9%, P= 0.86). No complications developed after procedure.
CONCLUSIONS
EUS-FNA can be a safe and efficient method for the diagnosis of liver mass and it is technically feasible even for those in the right lobe.
背景与目的
内镜超声引导下细针穿刺抽吸术（EUS-FNA）已被确立为诊断和分期腹内肿块的一种安全且准确的方法。然而，很少有研究调查其针对肝肿块的可行性、有效性及安全性。我们评估了EUS-FNA在包括右叶在内的肝肿块患者中的有效性和安全性。
患者与方法
在2010年9月至2016年2月期间，对47例有肝肿块的患者（左叶30例，右叶17例）进行了技术可行性、安全性及诊断率的评估。
结果
38例患者（80.9%）患有恶性肿瘤，而9例患者（19.1%）有良性肝肿块。技术成功率为97.9%（46/47）。EUS-FNA在42例患者中的38例（90.5%）具有诊断价值。当比较右肝肿块和左肝肿块EUS-FNA的结果时，两个叶的技术成功率相似（100%对94.1%，P = 0.2）。EUS上肿瘤的中位大小（25.5mm，四分位间距[IQR]13.8 - 30.3对28mm，IQR（18.5 - 43.5），P = 0.24）及穿刺针数（3，IQR 3 - 对3，IQR 3 - 3，P = 0.24）无显著差异。左叶获得足够标本的比例在统计学上更高（28/30，93.3%对14/17，82.4%，P = 0.04）。然而，肝肿块的诊断准确性并无差异（25/28，89.3%对13/14，92.9%，P = 0.86）。术后未发生并发症。
结论
EUS-FNA可以是诊断肝肿块的一种安全且有效的方法，即使对于右叶的肝肿块，在技术上也是可行的。
Zotero 插件