超声内镜引导下细针穿刺活检对纵隔和腹膜后淋巴结转移癌的诊断价值  

Diangostic value and safety of EUS-FNA in mediastinal and retroperitoneal lymph node metastasis cancer

作　　者：唐晓军[1] 罗勇[1] 冷倩倩 徐芬芬 TANG Xiao-jun;LUO Yong;LENG Qian-qian;XU Fen-fen(Department of Ultrasound Imaging,The People's Hospital of Songzi,Songzi Hubei 434200;Department of Ultrasound Imaging,Hubei General Hospital,Wuhan Hubei 430060,China)

机构地区：[1]湖北省松滋市人民医院超声影像科,434200 [2]湖北省人民医院超声影像科,湖北武汉430060

出　　处：《蚌埠医学院学报》2017年第9期1248-1251,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨超声内镜引导下细针穿刺活检(EUS-FNA)对纵隔和腹膜后淋巴结转移癌的诊断价值,并评价EUS-FNA的安全性。方法:回顾性分析119例纵隔和/或腹膜后淋巴结肿大怀疑恶性肿瘤转移,并伴或不伴实质或空腔脏器管壁占位病人的临床资料,共187处病灶行EUS-FNA,其中穿刺肿大淋巴结140个,穿刺实质或空腔脏器管壁占位47处。术后注意观察病人有无并发症,并随访细胞学、组织学检查结果。结果:119例病人中,EUS-FNA诊断淋巴结转移癌的敏感性、特异性、阳性预测值、阴性预测值、准确率分别为92.5%、100.0%、100.0%、86.7%、95.0%。47处实质或空腔脏器管壁占位,EUS-FNA诊断恶性肿瘤41例(包括原发肿瘤35例,转移性肿瘤6例),良性占位4例,2例诊断不明确。术后观察,1例病人出现胸痛不适,2例出现轻微腹痛不适,其中1例合并一过性发热,均给予对症处理后好转,余未出现出血、穿孔等并发症。结论:超声内镜可在一次操作中对多部位病灶进行EUS-FNA,获得病理学诊断;EUS-FNA对纵隔和腹膜后淋巴结转移癌的确诊具有肯定的价值;EUS-FNA可在实时超声监控下进行,安全性高,值得临床重视。Objective:To investigate the diangostic value and safety of the endoscopic ultrasound guided fine needle aspiration biopsy(EUS FNA)in mediastinal and retroperitoneal lymph node metastasis cancer.Methods:The data of119patients suspected by mediastinal and/or retroperitoneal lymph nodes tumor metastasis complicated with or without substance or hollow organ wall placeholder were retrospectively analyzed.A total of187lesions were treated with EUS FNA,and puncture lymph nodes in140cases and puncture the wall of hollow organs or substance placeholder in47cases were implemented.The postoperative complications in all cases were observed,and the results of cytology and histology were followed up.Results:Among119cases,the sensitivity,specificity,positive predictive value,negative predictive value and accuracy of EUS FNA in diagnosing the lymph nodes metastasis carcinoma were92.5%,100.0%,100.0%,86.7%and95.0%,respectively.The substance or hollow organ wall placeholder in47cases were found.The malignant carcinoma in41cases(including35cases of primary tumors and6cases of metastatic tumors),benign tumor in4cases and indefinite diagnosis in2cases were identified using EUS FNA.According to post operative observation,chest pain in1case,slight abdominal pain in2cases(including1cases complicated with transient fever)were identified,and the patients improved after symptomatic treatment.No bleeding and perforation were found.Conclusions:The pathological diagnosis of multi site lesions can be obtained using EUS FNA.EUS FNA has clinical certain value in the diagnosis of mediastinal and retroperitoneal lymph nodes metastasis carcinoma,which is safe by real time ultrasonography monitoring,and worthy of attention in clinic.

关 键 词：淋巴结肿瘤 超声内镜 细针穿刺 纵隔 腹膜后 

分 类 号：R733[医药卫生—肿瘤]