摘要
目的探讨内镜超声引导下细针穿刺活检（EUS—FNA）在上消化道壁外占位性病变（胰腺、纵隔、腹膜后占位）诊断中的应用价值。方法回顾性总结行EUS—FNA检查的33例胰腺占位、25例纵隔占位和13例腹膜后占位患者的临床资料，以手术病理或6个月临床随访结果作为最终诊断，统计EUS．FNA对不同分类上消化道壁外恶性占位诊断的敏感度、特异度、阳性预测值、阴性预测值和准确率。结果EUS—FNA诊断上消化道壁外恶性占位的总体敏感度、特异度、阳性预测值、阴性预测值、准确率分别为82．2％（37／45）、100．0％（26／26）、100．0％（37／37）、76．5％（26／34）、88．7％（63／71），且分别诊断胰腺、纵隔、腹膜后恶性占位的敏感度、特异度、阳性预测值、阴性预On,0值、准确率均较高。病灶直径〉3cm恶性占位EUS—FNA诊断的敏感度、特异度、阳性预测值、阴性预测值及准确率分别为81．0％（17／21）、100．0％（13／13）、100．0％（17／17）、76．5％（13／17）、88．2％（30／34），病灶直径≤3cm恶性占位的诊断敏感度、特异度、阳性预测值、阴性预测值及准确率分别为83．3％（20／24）、100．0％（13／13）、100．0％（20／20）、76．5％（13／17）、89．2％（33／37），两者比较差异均无统计学意义（P〉0．05）。71例患者均未出现出血、穿孔、胰腺炎、胰瘘及感染、胸痛、气胸等并发症。结论EUS—FNA是一种安全、准确、有效地诊断上消化道壁外占位性病变的方法，且诊断准确率不受病灶大小的影响。
Objective To evaluate significance of EUS-FNA in diagnosis of extramural lesions of upper gastrointestinal tract. Methods EUS-FNA was performed in 33 patients with pancreatic lesions, 25 with mediastinal and 13 with retroperitoneal masses, and the clinical data of these patients were evaluated retrospectively. The final diagnosis was determined by surgical resection or clinical follow-up for 6 months. The sensitivity, specificity, positive predictive value （PPV） , negative predictive value （NPV） and accuracy of EUS-FNA for varies extramural lesions of upper gastrointestinal tract were analyzed. Results The overall diagnostic sensitivity, specificity, PPV, NPV, accuracy of EUS-FNA were 82. 2% （37/45）, 100. 0% （26/26）, 100. 0% （37/37）, 76. 5% （26/34）, 88. 7% （63/71）, respectively. There was no significant difference in sensitivity, specificity, PPV, NPV, accuracy of EUS-FNA in diagnosis for lesions less than 3cm and larger than 3cm. There was no procedure related complication occurred in all 71 patients. Conclusion EUS-FNA is a safe, accurate and successful procedure in the diagnosis for extramural lesions of the upper gastrointestinal tract regardless to its size.
出处
《中华消化内镜杂志》
2013年第8期424-428,共5页
Chinese Journal of Digestive Endoscopy
关键词
活组织检查
细针
内窥镜超声检查
诊断
Biopsy, Fine-needle
Endoscopic ultrasonography
Diagnosis
