摘要
AIM： to evaluate the role of endoscopic ultrasonographyguided fine needle aspiration （EUS-FNA） in the preoperative diagnosis of gastrointestinal stromal tumor （GIST）.METHODS： From September 2002 to June 2006, Fiftythree consecutive EUS-FNAs of GI tract subepithelial hypoechoic tumors with continuity to proper muscle layer suspected as GIST by standard EUS were evaluated prospectively. The reference standards for the final diagnosis were surgery （n = 31）, or clinical follow-up （n = 22）. Additionally, immunophenotyping of specimens obtained by EUS-FNA and surgical resection specimens were compared.RESULTS： In 2 cases puncture was not performed because of anatomical problems. The collection rate of adequate specimens from the GI tract subepithelial hypoechoic tumor with continuity to proper muscle layer was 82% （42/51）. The diagnostic rate for the tumor less than 2 cm, 2 to 4 cm, and 4 cm or more were 71% （15/21）, 86% （18/21）, and 100% （9/9）,respectively. In 29 surgically resected cases, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of EUS-FNA using immunohistochemical analysis of GIST were 100%（24/24）, 80% （4/5）, 96% （24/25）, 100% （4/4）, and 97% （28/29）, respectively. No major complications were encountered.CONCLUSION： EUS-FNA with immunohistochemical analysis is a safe and accurate method in the pretherapeutic diagnosis of GIST. It should be taken into consideration in decision making, especially in early diagnosis following minimal invasive surgery for GIST.
瞄准：在胃肠的基质肿瘤(大意) 的外科手术前的诊断评估内视镜的指导 ultrasonography 的好针渴望(EUS-FNA ) 的角色。方法：从 2002 年 9 月到 2006 年 6 月，有到合适的肌肉层的连续性的上皮的低亚硫酸钠拟声肿瘤由标准 EUS 作为大意怀疑了的官方补给的道潜水艇的 53 连续 EUS-FNAs 有希望地被评估。为最后的诊断的参考标准是外科(n = 31 ) ，或临床的后续(n = 22 ) 。另外，标本的免疫 phenotyping 由 EUS-FNA 获得了，外科的切除术标本被比较。结果：因为解剖问题，没在 2 情况刺被执行。从官方补给的道的足够的标本的收集率与连续性代替上皮的低亚硫酸钠拟声肿瘤到合适的肌肉层是 82%(42/51 ) 。为肿瘤的诊断的率不到 2 厘米， 2 ～ 4 厘米，和 4 厘米或更多是 71%(15/21 ) ， 86%(18/21 ) ，并且 100%(9/9 ) 分别地。在 29 通过手术用免疫的 EUS-FNA 的 resected 盒子，敏感，特性，积极预兆的价值，否定预兆的价值，和诊断精确性大意的组织化学的分析是100%( 24/24 )，80%( 4/5 )，96%( 24/25 )，100%( 4/4 )，并且97%( 28/29 )分别地。没有主要复杂并发症被遇到。结论：有免疫的 EUS-FNA 组织化学的分析是在大意的 prethera-peutic 诊断的一个安全、精确的方法。它应该在决策被考虑，特别在跟随为大意的最小的侵略外科的早诊断。
