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叉尖针在内镜超声引导下对胃上皮下病变进行细针穿刺活检中的应用价值。

Usefulness of a Fork-Tip Needle in Endoscopic Ultrasound-Guided Fine-Needle Biopsy for Gastric Subepithelial Lesions.

作者信息

Takasumi Mika, Hikichi Takuto, Hashimoto Minami, Nakamura Jun, Kato Tsunetaka, Kobashi Ryoichiro, Yanagita Takumi, Suzuki Rei, Sugimoto Mitsuru, Sato Yuki, Irie Hiroki, Takagi Tadayuki, Kobayakawa Masao, Hashimoto Yuko, Ohira Hiromasa

机构信息

Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.

Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1295, Japan.

出版信息

Diagnostics (Basel). 2021 Oct 12;11(10):1883. doi: 10.3390/diagnostics11101883.

Abstract

The sample adequacy and diagnostic accuracy of an endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) have been reported to be imperfect. To resolve these issues, a fork-tip needle as an EUS-guided fine-needle biopsy (FNB) needle has been developed. This study was conducted to evaluate the usefulness of a fork-tip needle in an EUS-FNB for gastric SELs. Seventy-nine patients who received an EUS-FNA or FNB using a fork-tip needle for gastric SELs were included in the study. The sample adequacy and diagnostic accuracy were compared between the EUS-FNB with the fork-tip needle group (fork-tip group, = 13) and the EUS-FNA with FNA needle group (FNA group, = 66). In addition, a multivariate analysis of the factors influencing diagnostic accuracy was conducted. Regarding sample adequacy, there was no significant difference between the groups (100% vs. 90.9%, respectively; = 0.582). The diagnostic accuracy of the fork-tip group was numerically higher than that of the FNA group (92.3% vs. 81.8%, respectively; = 0.682). In a multivariate analysis, the diagnostic accuracy was related to the tumor size and location of the SEL but not to the needle type. In conclusion, this study does not show statistical superiority, but suggests the useful potential of a fork-tip needle.

摘要

据报道,内镜超声(EUS)引导下细针穿刺抽吸术(EUS-FNA)用于胃黏膜下病变(SELs)时,样本充足率和诊断准确性并不理想。为了解决这些问题,已开发出一种叉尖针作为EUS引导下细针活检(FNB)针。本研究旨在评估叉尖针在EUS-FNB用于胃SELs中的实用性。79例接受使用叉尖针进行EUS-FNA或FNB治疗胃SELs的患者纳入本研究。比较了使用叉尖针的EUS-FNB组(叉尖组,n = 13)和使用FNA针的EUS-FNA组(FNA组,n = 66)的样本充足率和诊断准确性。此外,对影响诊断准确性的因素进行了多变量分析。关于样本充足率,两组之间无显著差异(分别为100%和90.9%;P = 0.582)。叉尖组的诊断准确性在数值上高于FNA组(分别为92.3%和81.8%;P = 0.689)。在多变量分析中,诊断准确性与SEL的肿瘤大小和位置有关,而与针的类型无关。总之,本研究未显示出统计学上的优越性,但提示了叉尖针的潜在实用性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b46/8534775/cce2374f16f9/diagnostics-11-01883-g001.jpg

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