内镜超声引导下细针穿刺抽吸术诊断上消化道隆起性病灶的价值

摘要

Objective To investigate the accuracy and clinical application of endoscopic ultrasound guided fine needle aspiration(EUS-FNA) in diagnosis of occupying lesions in upper digestive tract. Methods Thirty-five patients with occupying lesions in upper digestive tract underwent endoscopic ultrasonagraphy and EUS-FNA between November 2011 and December 2013. The results of cytology and/or pathology were compared with surgical and follow-up findings. Results EUS-FNA was successfully performed on 35 lesions in oesophagus (11.43%), stomach(74.29%) and duodenalbulb(14.28%),with the success rate of 100%. Among them,the lesions in 29 patients (82.85%) were cytologically confirmed. The lesions in 10 of 15 patients (60.66%) were pathologically confirmed. Compared with the surgical and follow-up findings,the overall diagnostic accuracy of EUS-FNA was 85.71%(30/35). Conclusion EUS-FNA is a safe and effective method with high accuracy for diagnosis of occupying lesions in upper digestive tract and peripheral areas.%目的：探讨内镜超声引导下细针穿刺抽吸术（EUS-FNA）对上消化道隆起性病灶诊断准确性及其临床应用价值。方法对2011年11月至2013年12月间35例上消化道隆起病灶行超声内镜检查及超声内镜引导下的细针穿刺检查，对比细胞学和/或病理学检查与术后病理结果及随访结果。结果共35例病灶成功进行了EUS-FNA，穿刺成功率100%。其中病灶位于食管4例（11.43%），胃26例（74.29%），十二指肠球部5例（14.28%）。29例患者细胞学检查结果阳性，阳性率为82.85%（29/35）。15例患者获得组织碎片或组织细条行病理学检查，组织获得率为42.86%（15/35），其中10例病理学检查结果阳性，阳性率为60.66%（10/15）。与术后病理结果及长期随访结果对照，EUS-FNA后细胞学和/或病理学检查的诊断准确率为85.71%（30/35）。结论在上消化道及周围实质性占位病变中，EUS-FNA是一项安全、有效、准确的诊断及鉴别诊断方法。