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根据胃的位置,内镜超声引导下细针组织获取的诊断率。

Diagnostic yields of endoscopic ultrasound-guided fine-needle tissue acquisition according to the gastric location.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Hospital and Medical School, Gwangju, South Korea.

出版信息

Medicine (Baltimore). 2021 Jun 25;100(25):e26477. doi: 10.1097/MD.0000000000026477.

Abstract

The diagnostic accuracy of endoscopic ultrasound-guided fine-needle tissue acquisition (EUS-FNTA) according to the gastric location of subepithelial tumors (SETs) has not been well established. We aimed to evaluate the efficacy of EUS-FNTA for the diagnosis of gastric SETs according to tumor location.Thirty-three patients diagnosed with gastric SETs via EUS-FNTA from January 2016 to May 2018 were analyzed retrospectively. Patient demographics, diagnostic yields, and complications were evaluated.Nineteen patients (57.6%) were female, with a mean age of 57.7 years. Endoscopic ultrasound revealed a mean longitudinal diameter of 25.6 mm. The most common location of SETs was in the gastric body (n = 18, 54.5%), followed by cardia and fundus (n = 10, 30.3%), and antrum (n = 5, 15.2%). A 20-gauge biopsy needle was most frequently used (90.9%). The diagnostic yield was obtained in 23 patients (69.7%). The most common diagnosis was gastrointestinal stromal tumor (73.9%), followed by leiomyoma (17.4%). The diagnostic yield of SETs in gastric antrum (0/5, 0%) was significantly lower than that in the gastric body and cardia (23/28, 82.1%, P = .001). A case of immediate bleeding after EUS-FNTA occurred in 1 patient (3.0%) who recovered uneventfully. According to related literature, the overall diagnostic yield of SETs in gastric antrum was significantly lower than that in the gastric body, fundus, and cardia (29.7% vs 71.4%, P < .001, n = 191).EUS-FNTA is ineffective in the diagnosis of SETs in the gastric antrum. Although EUS-FNTA is an advanced diagnostic tool for gastric SETs, it is essential to develop more effective methods for the diagnosis of antral SETs.

摘要

内镜超声引导下细针组织采集(EUS-FNTA)对胃黏膜下肿瘤(SETs)的诊断准确性尚未得到充分证实。本研究旨在评估根据肿瘤位置判断 EUS-FNTA 对胃 SETs 的诊断效果。

回顾性分析了 2016 年 1 月至 2018 年 5 月期间通过 EUS-FNTA 诊断为胃 SETs 的 33 例患者。评估了患者的人口统计学特征、诊断率和并发症。

19 例(57.6%)为女性,平均年龄为 57.7 岁。内镜超声显示 SETs 的平均纵向直径为 25.6mm。SETs 最常见的位置是胃体(18 例,54.5%),其次是贲门和胃底(10 例,30.3%),胃窦(5 例,15.2%)。最常使用 20G 活检针(90.9%)。23 例(69.7%)获得了诊断性标本。最常见的诊断是胃肠道间质瘤(73.9%),其次是平滑肌瘤(17.4%)。胃窦 SETs 的诊断率(0/5,0%)明显低于胃体和贲门(23/28,82.1%,P=0.001)。1 例(3.0%)患者在 EUS-FNTA 后立即出现出血,经治疗后恢复顺利。根据相关文献,胃窦 SETs 的总体诊断率明显低于胃体、胃底和贲门(29.7%比 71.4%,P<0.001,n=191)。

EUS-FNTA 对胃窦 SETs 的诊断效果不佳。虽然 EUS-FNTA 是一种先进的胃 SETs 诊断工具,但开发更有效的胃窦 SETs 诊断方法至关重要。

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