Department of Internal Medicine, Pusan National University College of Medicine and Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok‑ro, Seo‑Gu, Busan, 49241, Republic of Korea.
Surg Endosc. 2022 Nov;36(11):8060-8066. doi: 10.1007/s00464-022-09243-5. Epub 2022 Apr 20.
Subepithelial tumors (SETs) in the upper gastrointestinal (GI) tract are frequently discovered during upper endoscopy, and their management is determined based on size and histopathological diagnosis. We aimed to evaluate the diagnostic performance of endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) in upper GI SETs of 2-5 cm in size.
We included 63 patients who underwent EUS-FNB for upper GI SETs of 2-5 cm in size between January 2013 and February 2020. The diagnostic yield of EUS-FNB, ability of EUS-FNB in discriminating malignant from non-malignant lesions, and histopathological concordance between EUS-FNB specimens and resected specimens were evaluated.
Successful acquisition of macroscopic tissue cores was possible in all 63 cases, and the diagnostic yield of EUS-FNB was 92.1% (58/63). The sensitivity, specificity, and accuracy of EUS-FNB in discriminating malignant from non-malignant lesions were 100% (95% confidence interval [CI] 85.3-100%), 87.8% (95% CI 79.9-87.8%), and 92.1% (95% CI 81.8-92.1%), respectively. Of the 26 SETs that were endoscopically or surgically resected after EUS-FNB, the histopathological concordance rate between the EUS-FNB specimens and resected specimens was 100% (24/24), except in two cases of inadequate results with EUS-FNB specimens.
EUS-FNB provides high diagnostic yield and high capability in discriminating malignant from non-malignant lesions in upper GI SETs of 2-5 cm in size.
在上消化道内镜检查中经常发现上消化道(subepithelial tumors, SET)，其处理方法取决于大小和组织病理学诊断。本研究旨在评估内镜超声引导下细针穿刺活检(endoscopic ultrasonography-guided fine-needle biopsy, EUS-FNB)在 2-5cm 大小的上消化道 SET 中的诊断性能。
我们纳入了 2013 年 1 月至 2020 年 2 月期间因 2-5cm 大小的上消化道 SET 而行 EUS-FNB 的 63 例患者。评估了 EUS-FNB 的诊断效能、EUS-FNB 鉴别良恶性病变的能力，以及 EUS-FNB 标本与切除标本的组织病理学一致性。
所有 63 例患者均成功获得了大体组织芯，EUS-FNB 的诊断率为 92.1%（58/63）。EUS-FNB 鉴别良恶性病变的敏感性、特异性和准确性分别为 100%（95%置信区间 [CI] 85.3-100%）、87.8%（95% CI 79.9-87.8%）和 92.1%（95% CI 81.8-92.1%）。在 EUS-FNB 后进行内镜或手术切除的 26 个 SET 中，EUS-FNB 标本与切除标本的组织病理学一致性率为 100%（24/24），但有 2 例 EUS-FNB 标本结果不充分。
EUS-FNB 在上消化道 2-5cm 大小的 SET 中具有较高的诊断效能和鉴别良恶性病变的能力。
