Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions
Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions
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超声内镜引导下细针抽吸在肿块性病变诊断中的作用
DOI：
10.3892/etm.2016.3433
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发表时间：
2016-08-01
影响因子：
2.7
通讯作者：
Hou, Xiaohua
中科院分区：
文献类型：
--
作者：
Han, Chaoqun;Lin, Rong;Hou, Xiaohua
超声内镜引导细针抽吸术 (EUS-FNA) 是一种精确的胰腺和纵隔取样技术；然而，其他肿块病变的可用数据有限。本研究的目的是探讨EUS-FNA在所有肿块病变鉴别诊断中的价值。回顾性分析接受 EUS-FNA 诊断肿块病变（包括胰腺、纵隔、腹腔和腹膜后病变）的患者的数据。通过将FNA结果与非手术病例的病理检查或随访监测结果进行比较来计算准确性。共纳入150例。肿块的位置从胰腺（n=62）到纵隔（n=29）、胃肠道（n=36）、腹腔和腹膜后（n=23）。 EUS-FNA诊断所有病变的敏感度为92.97%，约登指数为0.93。胰腺、纵隔、胃肠道、腹腔和腹膜后病变的诊断准确率分别为85.48%、89.66%、83.33%和78.23%。肿块分为实质器官（n=66）、管腔器官（n=36）和肿大淋巴结（n=33）。实质器官的病变可能比管腔器官的病变更大（P=0.03），并且淋巴结肿大（P=0.01）。对于占总肿块63.3%和14.7%的实性肿块和囊性肿块，诊断准确性没有显着差异（P=0.56）；然而，这两组之间的病变大小存在显着差异（P=0.04），并且大多数囊性肿块是在女性中发现的（P=0.03）。恶性病变在老年（P=0.01）和男性（P=0.03）患者中更常见。总之，EUS-FNA 是诊断不明原因肿块病变的有效工具；它通过确定适当的治疗方法来影响患者的管理。
Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youden's index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified.