超声内镜引导下细针穿刺联合流式细胞术诊断胃肠淋巴瘤初探

Endoscopic ultrasound guided fine needle aspiration in combination with flow cytometry in the diagnosis of gastrointestinal iymphoma

目的评价超声内镜引导下细针穿刺（EUS-FNA）联合流式细胞术（FCM）对淋巴瘤的诊断价值。方法回顾性分析2011年1月至12月上海瑞金医院收治的疑似淋巴瘤患者，行EUS-FNA且穿刺标本行FcM检测，以手术或活组织检查病理和随访结果为最终诊断，初步分析EUS-FNA联合FCM对淋巴瘤诊断的灵敏度、特异度、准确度。结果共收集14例疑似淋巴瘤患者，最终经手术病理或活组织检查病理确诊为淋巴瘤8例，非淋巴瘤性病变4例，2例患者未得到最终诊断。单独依靠FCM对淋巴瘤诊断的灵敏度均为4／8，特异度为4／4。EUS-FNA联合FCM检出淋巴瘤6例，对淋巴瘤诊断的灵敏度为6／8，特异度为4／4，准确度为10／12。结论EUS-FNA联合FCM对淋巴瘤具有较好的诊断价值，尤其对于胃肠道及其周边深部病变更具显著优势。

Objective To evaluate the diagnostic value of endoscopic ultrasound guided fine needle aspiration （EUS-FNA） in combination with flow cytometry （FCM） in lymphoma. Methods From January 2011 to December 2011, the cases of suspicious lymphoma with EUS-FNA examination at Shanghai Ruijin Hospital were retrospectively analyzed. The final diagnosis was according to pathological diagnosis of specimen from the surgery and follow-up results. The sensitivity, specificity and accuracy of EUS-FNA combined with FCM in lymphoma diagnosis were initially analyzed. Results A total of 14 suspicious lymphoma patients were collected, eight cases were diagnosed as lymphoma by pathological examination of specimen from the surgery or. tissue from aspiration, four cases were non-lymphoma lesions and two cases still had no final diagnosis. The sensitivity and specificity of FCM alone in lymphoma diagnosis were 4/8 and 4/4 respectively. Six cases of lymphoma were detected by EUS-FNA with FCM. The sensitivity, specificity and accuracy of EUS-FNA combined with FCM were 6/8, 6/6 and 10/12 respectively. Conclusion EUS-FNA combined with FCM has better diagnostic value in lymphoma, especially for gastrointestinal lymphoma and those surrounding deep lesions.