经支气管镜和内镜超声引导下细针抽吸术的性能参数评估与比较，以及操作者经验的影响。
Evaluation and Comparison of Performance Parameters and Impact of Telepathology and Operator Experience on Endobronchial and Endoscopic Ultrasound-Guided Fine-Needle Aspiration.
机构信息
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
Department of Pulmonary, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis.
出版信息
Am J Clin Pathol. 2021 Apr 26;155(5):755-765. doi: 10.1093/ajcp/aqaa179.
OBJECTIVES
Endobronchial ultrasound- and endoscopic ultrasound-guided fine-needle aspiration (EBUS-/EUS-FNA) are minimally invasive techniques of diagnosing and staging malignancies. The procedures are difficult to master, requiring specific feedback for optimizing yield.
METHODS
Over 2 years, EBUS-/EUS-FNA cases were gathered using the institutional pathology database. Patient and specimen characteristics were collected from the pathology database and electronic medical record.
RESULTS
In 2 years, 789 unique FNA specimens were collected (356 EBUS and 433 EUS specimens). The cohort and each subgroup had excellent performance, which was enhanced by telepathology. The discrepancy rate was satisfactorily low. Hematolymphoid neoplasms are overrepresented in discrepant EBUS cases. The malignancy rates of cytology diagnostic categories were comparable to the literature.
CONCLUSIONS
Using diagnostic yield and concordance results allow for comprehensive evaluation of the entire process of EBUS-/EUS-FNAs. This study's findings can influence patient management, training methods, and interpretation of results, while also acting as a model for others to investigate their own sources of inadequacy, discrepancy, and training gaps.
目的
经支气管超声引导下细针抽吸术（EBUS-FNA）和内镜超声引导下细针抽吸术（EUS-FNA）是诊断和分期恶性肿瘤的微创技术。这些操作很难掌握，需要特定的反馈来优化产量。
方法
在 2 年期间，使用机构病理学数据库收集了 EBUS-FNA/EUS-FNA 病例。从病理学数据库和电子病历中收集了患者和标本特征。
结果
在 2 年内，共收集了 789 份独特的 FNA 标本（356 份 EBUS 和 433 份 EUS 标本）。该队列和每个亚组的表现都非常出色，远程病理学技术增强了这一效果。差异率令人满意地较低。血液淋巴肿瘤在不一致的 EBUS 病例中占比过高。细胞学诊断类别的恶性肿瘤率与文献相似。
结论
使用诊断产量和一致性结果可以全面评估 EBUS-FNA 和 EUS-FNA 的整个过程。本研究的结果可以影响患者管理、培训方法和结果解释，同时也可以作为其他研究机构调查自身不足、差异和培训差距的模型。
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