重复超声内镜引导细针穿刺抽吸术的临床价值  

Clinical value of repeated endoscopic ultrasound-guided fine-needle aspiration

作　　者：高军 许新彦 马瑞光 马苗淼 李真[2] 钟宁[2] Gao Jun;Xu Xinyan;Ma Ruiguang;Ma Miaomiao;Li Zhen;Zhong Ning(Department of Gastroenterology,Shandong Sunshine Union Hospital,Weifang 261061,China;Department of Gastroenterology,Qilu Hospital of Shandong University,Jinan 250012,China)

机构地区：[1]山东阳光融和医院消化内科,潍坊261061 [2]山东大学齐鲁医院消化内科,济南250012

出　　处：《中华消化内镜杂志》2025年第3期207-211,共5页Chinese Journal of Digestive Endoscopy

基　　金：国家自然科学基金(82261160396);泰山学者工程专项经费(tsqn202306344);山东大学临床研究项目(2021SDUCRCB004)。

摘　　要：目的探讨重复超声内镜引导细针穿刺抽吸术(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)在疑诊肿瘤性病变患者中的诊断价值。方法收集山东大学齐鲁医院消化内镜中心2018年1月至2023年10月期间因临床疑诊肿瘤性病变行首次EUS-FNA不能获得明确的疾病诊断而行重复EUS-FNA的所有病例,回顾超声内镜图像、病理、随访转归等病例资料,分析经重复EUS-FNA得到明确诊断的患者,评估重复EUS-FNA对肿瘤性病变的诊断敏感度、特异度、阳性预测值、阴性预测值及准确率。结果共有36例不同部位占位性病变患者纳入研究,最终80.6%(29/36)诊断为肿瘤性病变,19.4%(7/36)为非肿瘤性病变,其中34例患者得到明确病种诊断。重复EUS-FNA诊断肿瘤性病变灵敏度为82.8%(24/29),特异度为100.0%(7/7),阳性预测值为100.0%(24/24),阴性预测值为58.3%(7/12),准确率为86.1%(31/36)。结论临床疑诊肿瘤性病变而首次EUS-FNA病理结果不明确时,重复EUS-FNA是有效可行的方法。Objective To investigate the diagnostic value of repeated endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)in patients with suspected neoplastic lesions.Methods Patients with clinically suspected neoplastic lesions,who did not receive a definitive diagnosis following the initial EUS-FNA and subsequently underwent repeated EUS-FNA,were collected from the gastrointestinal endoscopy center of Qilu Hospital of Shandong University from January 2018 to October 2023.The ultrasonographic endoscopic images,pathology,and follow-up data were reviewed.Patients with confirmed diagnoses following repeated EUS-FNA were analyzed to determine the diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of repeat EUS-FNA for tumor and non-neoplastic lesions.Results A total of 36 patients with space-occupying lesions in different parts were included in the study,and the final diagnosis was 80.6%(29/36)of tumor lesions and 19.4%(7/36)of non-tumor lesions.Among these,34 patients received definitive diagnoses.The diagnostic sensitivity of repeated EUS-FNA for tumor was 82.8%(24/29),the specificity was 100.0%(7/7),the positive predictive value was 100.0%(24/24),the negative predictive value was 58.3%(7/12),and the accuracy was 86.1%(31/36).Conclusion Repeated EUS-FNA proves to be an effective and practical approach for cases where is suspicion of neoplastic lesions and the initial EUS-FNA pathology findings remain inconclusive.

关 键 词：穿刺术 超声内镜 细针穿刺 肿瘤性病变 

分 类 号：R730.4[医药卫生—肿瘤]