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使用活检针经内镜超声引导对肝脏实性肿块进行肝活检

Endoscopic Ultrasound-Guided Liver Biopsy Using a Core Needle for Hepatic Solid Mass.

作者信息

Chon Hyung Ku, Yang Hee Chan, Choi Keum Ha, Kim Tae Hyeon

机构信息

Division of Pancreato-Biliary, Department of Internal Medicine, Wonkwang University College of Medicine and Hospital, Iksan, Korea.

Department of Internal Medicine, Chonbuk University College of Medicine and Hospital, Jeonju, Korea.

出版信息

Clin Endosc. 2019 Jul;52(4):340-346. doi: 10.5946/ce.2018.175. Epub 2019 Jul 15.

Abstract

BACKGROUND/AIMS: This study aimed to evaluate the feasibility and efficacy of endoscopic ultrasound-guided fine needle biopsy (EUSFNB) using a core needle for hepatic solid masses (HSMs). Additionally, the study aimed to assess factors that influence the diagnostic accuracy of EUS-FNB for HSMs.

METHODS

A retrospective analysis of patients who underwent EUS-FNB for the pathological diagnosis of HSMs was conducted between January 2013 and July 2017. The procedure had been performed using core needles of different calibers. The assessed variables were mass size, puncture route, needle type, and the number of needle passes.

RESULTS

Fifty-eight patients underwent EUS-FNB for the pathologic evaluation of HSMs with a mean mass size of 21.4±9.2 mm. EUSFNB was performed with either a 20-G (n=14), 22-G (n=29) or a 25-G core needle (n=15). The diagnostic accuracy for this procedure was 89.7%, but both specimen adequacy for histology and available immunohistochemistry stain were 91.4%. The sensitivity and specificity of EUS-FNB were 89.7% and 100%, respectively. There was one case involving bleeding as a complication, which was controlled with endoscopic hemostasis. According to the multivariate analysis, no variable was independently associated with a correct final diagnosis.

CONCLUSION

EUS-FNB with core biopsy needle is a safe and highly accurate diagnostic option for assessing HSMs. There were no variable factors associated with diagnostic accuracy.

摘要

背景/目的:本研究旨在评估使用粗针进行内镜超声引导下细针穿刺活检(EUS-FNB)对肝脏实性肿块(HSMs)的可行性和有效性。此外,该研究旨在评估影响EUS-FNB对HSMs诊断准确性的因素。

方法

对2013年1月至2017年7月间接受EUS-FNB以进行HSMs病理诊断的患者进行回顾性分析。该操作使用了不同口径的粗针。评估的变量包括肿块大小、穿刺路径、针型和穿刺针数。

结果

58例患者接受了EUS-FNB以对HSMs进行病理评估,平均肿块大小为21.4±9.2mm。EUS-FNB使用20G(n=14)、22G(n=29)或25G粗针进行(n=15)。该操作的诊断准确性为89.7%,但组织学标本充足率和可用免疫组化染色率均为91.4%。EUS-FNB的敏感性和特异性分别为89.7%和100%。有1例并发症为出血,通过内镜止血得以控制。根据多变量分析,没有变量与正确的最终诊断独立相关。

结论

使用粗针活检针进行EUS-FNB是评估HSMs的一种安全且高度准确的诊断选择。没有与诊断准确性相关的可变因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9922/6680015/4e51704c2872/ce-2018-175f1.jpg

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