Hospital for Small Animals, The Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush Campus, Midlothian, UK.
J Small Anim Pract. 2024 Oct;65(10):749-758. doi: 10.1111/jsap.13759. Epub 2024 Jul 3.
The aim was to assess the technical success of percutaneous ultrasound-guided fine needle aspirates of gastrointestinal wall lesions and evaluate predictors of success. Secondary aims included comparing the cytological diagnosis with histopathology, evaluating the utility of concurrent locoregional lymph node cytology and assessing the procedure's complication rate.
Gastrointestinal wall cytology from 75 dogs and 70 cats obtained between 2018 and 2023 were reviewed and categorised as successful (resulting in a diagnostic cytology report) and accurate (resulting in the correct diagnosis when compared to histopathology). Unsuccessful fine needle aspirates, not submitted for cytology, were not recorded. Variables recorded included animal signalment, lesion and lymph node's appearance on ultrasound, size, location, number of smears submitted and experience of the ultrasonographer.
One hundred and fifty-two reports were analysed. Eighty-eight (58%) were successful: three normal epithelium, 21 inflammatory processes and 64 neoplasms. Variables associated with increased technical success included description of a mass, higher number of slides submitted and thickness of gastrointestinal lesion on ultrasound. Comparison with histopathology, performed for 17 lesions, showed discrepancies in eight, complete agreement in seven and partial in two. Eighty-four loco-regional lymph nodes were sampled, of which, 67 were successful (80%) and 52 brought additional clinical information (supporting GI wall cytology or diagnosing neoplasia not identified on GI wall cytology). No complication strictly attributable to gastrointestinal wall sampling was reported but when possibly related, death of the patient occurred in 2.5% of cases.
Ultrasound-guided fine needle aspirate of gastrointestinal wall had moderate accuracy and was unsuccessful in 42% of cases, but technical success increased when sampling mass lesions, thicker intestinal layers and submitting more slides.
评估经皮超声引导下胃肠道壁病变细针抽吸的技术成功率，并评估其成功的预测因素。次要目标包括比较细胞学诊断与组织病理学，评估同期局部淋巴结细胞学的效用，并评估该程序的并发症发生率。
回顾了 2018 年至 2023 年间 75 只狗和 70 只猫的胃肠道壁细胞学检查结果，并将其分为成功（获得诊断性细胞学报告）和准确（与组织病理学相比，结果为正确诊断）。未进行细胞学检查的不成功细针抽吸未被记录。记录的变量包括动物的特征、超声下病变和淋巴结的外观、大小、位置、提交的涂片数量和超声医师的经验。
共分析了 152 份报告。88 份（58%）为成功：3 份正常上皮，21 份炎症过程和 64 份肿瘤。与技术成功率增加相关的变量包括描述肿块、提交的涂片数量较多和胃肠道病变的超声厚度。与组织病理学比较，对 17 个病变进行了比较，结果在 8 个中有差异，在 7 个中有完全一致，在 2 个中有部分一致。对 84 个局部淋巴结进行了取样，其中 67 个（80%）成功，52 个（80%）提供了额外的临床信息（支持胃肠道壁细胞学检查或诊断未在胃肠道壁细胞学检查中发现的肿瘤）。没有严格归因于胃肠道壁取样的并发症，但可能与胃肠道壁取样有关的并发症，2.5%的病例发生死亡。
经皮超声引导下胃肠道壁细针抽吸术具有中等准确性，42%的病例不成功，但当取样肿块、较厚的肠层和提交更多的涂片时，技术成功率增加。
