Wang Wenli, Han Chaoqun, Ling Xin, Guo Xianwen, Liu Jun, Lin Rong, Ding Zhen
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Division of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Front Med (Lausanne). 2023 Aug 31;10:1221085. doi: 10.3389/fmed.2023.1221085. eCollection 2023.
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an established method for the evaluation of abdominal organ lesions. However, there are few studies on EUS-FNA for abdominal lymph node (LN) lesions. The purpose of this study was to evaluate the diagnostic role of EUS-FNA in isolated abdominal lymphadenopathy (LAP).
A retrospective analysis was performed on patients with isolated abdominal LAP who underwent a EUS-FNA examination. The diagnosis was made based on cytology, histology, and immunohistochemical (IHC) studies. The area under curve (AUC) value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated.
A total of 99 patients were included in this study. The final diagnoses were metastatic tumor ( = 32), lymphoma ( = 32), tuberculosis ( = 17), sarcoidosis ( = 5), castleman's disease ( = 1), and reactive LAP ( = 12). The AUC value, sensitivity, specificity, PPV, NPV, and accuracy of EUS-FNA in the diagnosis of malignant LAP were 0.9531, 90.6, 100, 100, 85.4, and 93.9%, respectively. For the diagnosis of lymphoma, the accuracy of EUS-FNA combined with IHC staining was 94.9%. Retroperitoneal LN enlargement is more commonly associated with lymphoma, while hepatic hilar LN enlargement predominantly suggests benign conditions or metastatic tumors. Malignant lymph nodes are more likely to be regular border, circular/quasi-circular, and fusion. Lymphomas are more likely to present with fusion and heterogeneous echogenicity than metastatic tumors.
EUS-FNA is a safe and effective method to diagnose isolated abdominal LAP.
超声内镜引导下细针穿刺抽吸术（EUS-FNA）是评估腹部器官病变的既定方法。然而，关于EUS-FNA用于腹部淋巴结（LN）病变的研究较少。本研究的目的是评估EUS-FNA在孤立性腹部淋巴结病（LAP）中的诊断作用。
对接受EUS-FNA检查的孤立性腹部LAP患者进行回顾性分析。诊断基于细胞学、组织学和免疫组织化学（IHC）研究。计算曲线下面积（AUC）值、敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和准确性。
本研究共纳入99例患者。最终诊断为转移性肿瘤（n = 32）、淋巴瘤（n = 32）、结核病（n = 17）、结节病（n = 5）、卡斯特曼病（n = 1）和反应性LAP（n = 12）。EUS-FNA诊断恶性LAP的AUC值、敏感性、特异性、PPV、NPV和准确性分别为0.9531、90.6%、100%、100%、85.4%和93.9%。对于淋巴瘤的诊断，EUS-FNA联合IHC染色的准确性为94.9%。腹膜后LN肿大更常与淋巴瘤相关，而肝门LN肿大主要提示良性疾病或转移性肿瘤。恶性淋巴结更可能边界规则、呈圆形/准圆形且融合。与转移性肿瘤相比，淋巴瘤更可能表现为融合和不均匀回声。
EUS-FNA是诊断孤立性腹部LAP的安全有效方法。
