Min Liang, Qing Yumin, Chu Yi, Liang Chengbai, Lv Liang, Liu Deliang, Tan Yuyong, Zhou Yuqian
Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha 410011, China.
Research Center of Digestive Disease, Central South University, Changsha 410011, China.
J Clin Med. 2023 Mar 9;12(6):2153. doi: 10.3390/jcm12062153.
(1) Background: The accurate diagnosis of esophageal strictures is quite critical for optimizing medical intervention. However, the diagnosis of suspicious malignant esophageal strictures with intact mucosa appearance and negative biopsy results is challenging. This study aimed to evaluate the role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in the diagnosis of suspicious esophageal strictures. (2) Methods: We retrospectively analyzed the cases with suspicious malignant esophageal strictures that underwent EUS-FNA, with or without rapid on-site evaluation (ROSE), in our hospital from April 2017 to September 2022. Their clinical manifestations, imaging examinations, gastroscopic examinations, EUS-FNA results, and therapeutic strategies were retrospectively recorded and analyzed. (3) Results: A total of 23 patients (15 male and 8 female) were enrolled in this study. Based on EUS-FNA results, 18 patients were diagnosed with malignancies, including 16 cases of primary esophageal cancer (13 squamous carcinomas and 3 adenocarcinomas), 1 case of mediastinal cancer, and 1 case of metastatic esophageal cancer; 1 case of tuberculosis was also confirmed by EUS-FNA. Among 4 cases of ambiguous diagnosis with EUS-FNA, 1 was diagnosed with an esophageal glomus tumor after surgical removal, and 2 patients survived for several years without medical intervention, which hinted at the possibility of benign esophageal strictures. No major complications, including bleeding or perforation, were observed. (4) Conclusions: EUS-FNA may serve as a safe and effective diagnostic tool in suspicious malignant esophageal strictures with accurate specimen acquisition, especially for biopsy-negative cases.
(1) 背景：食管狭窄的准确诊断对于优化医疗干预至关重要。然而，诊断黏膜外观完整且活检结果为阴性的可疑恶性食管狭窄具有挑战性。本研究旨在评估内镜超声引导下细针穿刺抽吸术（EUS-FNA）在可疑食管狭窄诊断中的作用。(2) 方法：我们回顾性分析了2017年4月至2022年9月在我院接受EUS-FNA检查（无论有无快速现场评估[ROSE]）的可疑恶性食管狭窄病例。回顾性记录并分析了他们的临床表现、影像学检查、胃镜检查、EUS-FNA结果及治疗策略。(3) 结果：本研究共纳入23例患者（男性15例，女性8例）。根据EUS-FNA结果诊断为恶性肿瘤的患者有18例，其中原发性食管癌16例（鳞状细胞癌13例，腺癌3例），纵隔癌1例，食管转移癌1例；EUS-FNA还确诊了1例结核病。在EUS-FNA诊断不明确的4例病例中，1例在手术切除后诊断为食管血管球瘤，2例患者未经医疗干预存活数年，提示可能为良性食管狭窄。未观察到包括出血或穿孔在内的严重并发症。(4) 结论：EUS-FNA可作为一种安全有效的诊断工具，用于可疑恶性食管狭窄的诊断，能准确获取标本，尤其适用于活检阴性的病例。
