内镜超声引导下细针穿刺活检对占位性病变的诊断价值

Diagnostic Value of Endoscopic Ultrasound-guided Fine-needle Aspiration on Space-occupying Lesions

背景：内镜超声引导下细针穿刺活检（EUS—FNA）广泛应用于占位性病变的诊断，但其诊断价值尚未完全明确。目的：评价EUS—FNA对占位性病变的诊断价值。方法：纳入2010年12月～2012年12月于华中科技大学同济医学院附属协和医院就诊的占位性病变患者70例，对占位性病变行EUS—FNA检查，以术后病理诊断作为金标准，评价EUS·FNA的阳性预测值、阴性预测值、敏感性、特异性、准确性以及约登指数。结果：66例患者获得足够细胞或组织学标本，穿刺成功率为94．3％。穿刺成功患者（66例）中，EUS—FNA的阳性预测值、阴性预测值、敏感性、特异性、准确性、约登指数分别为100％、36．4％、88．7％、100％、89．4％和0．887；所有穿刺患者（70例）中，上述数值分别为100％、26．7％、83．3％、100％、84．3％和0．833。所有患者均未发生严重并发症。结论：EUS—FNA对诊断占位性病变安全、有效，具有重要临床价值。

Background： Endoscopic ultrasound-guided fine-needle aspiration （EUS-FNA） has been widely used in the diagnosis of space-occupying lesions, however, its diagnostic value is still not fully clear. Aims ： To assess the diagnostic value of EUS-FNA on space-occupying lesions. Methods： A total of 70 patients with space-occupying lesions from December 2010 to December 2012 at Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology were enrolled and had EUS-FNA performed. Postoperative pathology was used as a golden standard. The positive predictive value, negative predictive value, sensitivity, specificity, accuracy and Youden＇ s index of EUS-FNA were evaluated. Results： Adequate specimen was obtained by EUS-FNA in 66 of the 70 patients, with a successful rate of 94.3%. In 66 patients with adequate specimen, the positive predictive value, negative predictive value, sensitivity, specificity, accuracy and Youden＇ s index of EUS-FNA were 100% , 36.4% , 88.7% , 100%, 89.4% and 0. 887, respectively, while in all of the 70 patients were 100%, 26.7%, 83.3%, 100%, 84.3% and 0. 833, respectively. No serious complications were found. Conclusions： EUSFNA is a safe and effective diagnostic modality for space-occupying lesions.