内镜超声引导细针湿抽法诊断实体肿瘤的多中心研究  

A multi-center study of wet suction technique under endoscopic ultrasound for solid lesions

作　　者：李百文[1] 胡端敏[2] 诸琦 宛新建[1] 李玉霞[1] 徐凯[4] 任迎春[1] 武文娟[1] 唐文[2] 

机构地区：[1]上海交通大学附属第一人民医院消化科,上海200080 [2]苏州大学附属第二医院消化科 [3]百汇华鹰医疗中心百汇医疗 [4]上海市松江区中心医院消化科

出　　处：《中华消化内镜杂志》2016年第5期282-286,共5页Chinese Journal of Digestive Endoscopy

基　　金：国家自然科学基金资助项目（81572316）;上海市科委医学引导项目（14411966900）;上海交通大学医工交叉面上项目（YG2014MS24）

摘　　要：目的探讨内镜超声引导下不同细针穿刺抽吸活检方法（干抽法和湿抽法）对实体肿瘤的诊断价值。方法22例消化系统占位性病变确诊为恶性实体肿瘤，均在EUS引导下同时进行干抽细针活检和湿抽细针活检，采取的样本分别进行细胞学及组织病理学检查，比较2种方法所获取组织细胞标本的质量及诊断的准确率。结果22例患者中干抽法与湿抽法的组织细胞学诊断阳性率分别为27．27％（6／22）和45．45％（10／22）（P〉0．05）；干抽法与湿抽法的组织病理学诊断阳性率分别为40．91％（9／22）和72．73％（16／22）（P〈0．05）；细胞涂片中每高倍镜下细胞计数湿抽法较干抽法明显增加，分别为（45．5±11．5）和（26．0＋9．5）（P〈0．05）；湿抽法穿刺组织条积分较干抽法积分高，分别为（4．3±1．5）和（2．9±1．4）（P〈0．05）。22例患者中细胞学与组织病理学联合诊断干抽法与湿抽法的诊断阳性率分别为45．45％（10／22）和81．82％（18／22），2组问差异具有统计学意义（P〈0．05）；联合诊断较单独细胞学或组织病理学诊断阳性率高。结论EUS—FNA湿抽法简单易行，病理取材样本质量高，诊断阳性率高，对实体肿瘤的诊断价值优于干抽法，值得在临床中推广。Objective To compare the diagnostic values of different endoscopic ultrasound guided fine needle aspiration （EUS-FNA） biopsy methods （ dry suction technique and wet suction technique） for solid tumors. Methods A total of 22 cases diagnosed as having digestive malignant tumors were enrolled, in each case endoscopic ultrasound （EUS） guided dry-FNA and wet-FNA were simuhaneously carried out. Samples were taken respectively for cytologic and histopathologie examination. Then the quality of tissue specimens and diagnostic accuracy between the two groups were compared. Results The positive diagnostic rates of dry-FNA and wet-FNA in cytologic pathology were 27.27% （6/22） and 45.45% （10/22） without significant difference （ P〉0. 05）. The positive diagnostic rates of dry-FNA and wet-FNA in histopathology were 40. 91% （9/22）and 72. 73% （ 16/22 ,P〈0. 05）. The cell count in wet-FNA was higher than that in dry-FNA （45.5±11.5 VS 26.0±9.5,P〈0. 05）.The puncture tissue scores in wet-FNA was higher than that in dry- FNA （4. 3±1.5 VS 2.9±1.4,P〈0. 05）. In 22 cases, the combined diagnostic positive rates of cytologic and histopathologic examination in dry-FNA and wet-FNA were 45.45% （10/22） and 81.82% （ 18/22, P〈0. 05） , which were significantly higher than those in separate cytologic or histologic examination （P〈0. 05）. Conclusion Wet-FNA method is simple and easy to operate, which provides high quality samples and good diag-nostic positive rate. It has the superior value to dry-FNA in the diagnosis of solid tumors.

关 键 词：病理学 内镜超声引导下细针抽吸术 干抽 湿抽 

分 类 号：R735[医药卫生—肿瘤]