Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound(TRUS)-guided multiple biopsy of the prostate,but is usually mild and stops spontaneously.We report what is believed to be the first case...Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound(TRUS)-guided multiple biopsy of the prostate,but is usually mild and stops spontaneously.We report what is believed to be the first case of life-threatening rectal bleeding following this procedure,which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding.This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy.Additionally,current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure,are described.展开更多
Squamous cell carcinoma of the pancreas has been sparsely described since the 1940s,and generally has a poor prognosis.Herein,we present a case of primary squamous cell carcinoma of the pancreas with liver metastasis,...Squamous cell carcinoma of the pancreas has been sparsely described since the 1940s,and generally has a poor prognosis.Herein,we present a case of primary squamous cell carcinoma of the pancreas with liver metastasis,both confirmed by endoscopic ultrasoundguided fine needle aspiration(EUS-FNA).To the best of our knowledge,this is the first case report in literature utilizing EUS-FNA for a cell-type specific diagnosis of primary pancreatic squamous cell carcinoma with a liver metastasis.展开更多
AIM:To investigate the usefulness of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in the differentiation of autoimmune pancreatitis(AIP).METHODS:We retrospectively reviewed 47 of 56 AIP patients who un...AIM:To investigate the usefulness of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in the differentiation of autoimmune pancreatitis(AIP).METHODS:We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria.On 47 EUS-FNA specimens,we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis(LPSP) and idiopathic duct-centric pancreatitis(IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP.A disposable 22-gauge needle was used for EUS-FNA.RESULTS:Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA.EUS-FNA was performed from the pancreatic head in 21 cases,which is known to be technically difficult when performed by core biopsy;there was no significant difference in the results compared with pancreatic body-tail.Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP.No one met level 1 findings of IDCP,but 3 patients met level 2 findings of IDCP.Of 10 seronegative cases,2 cases were diagnosed with "definitive type 1 AIP",and 3 cases were diagnosed with "probable type 2 AIP" when considering both the level 2 histological findings and response to steroids.CONCLUSION:EUS-FNA is useful in the differentiation of type 1 and type 2 AIP,particularly in seronegative cases.展开更多
Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases. Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytol...Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases. Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytology (FNAC) were obtained and analyzed from a consecutive of 102 women with palpable breast masses, results were correlated with the histopathological findings. Results: Of the 102 cases, malignancy was confirmed in 43 cases (42.16%) by final pathological examination, the sensitivity and specificity of cancer detection with FNA cytology was 90.7% (39/43) and 89.8% (53/59), re- spectively, the whole accuracy was 90.2% (92/102), with a positive predictive value of 86.7% (39/45) and a negative predictive value of 93.0% (53/57). FFDM gave a sensitivity of 88.4% (38/43), specificity of 83.1% (49/59), and whole accuracy 85.3% (87/102), the positive predictive value and negative predictive value was 79.2% (38/48) and 90.7% (49/54), respectively. All the FNAC-negative cancer cases were suggestive of malignancy by FFDM findings, however, the benign cases which present as equivocal finding by FNA cytology, could not be ruled out the presence of malignancy. Conclusion: FNAC and FFDM both are accurate, effective and economical diagnostic modalities, combined use of these two methods can reduced the misdiag- nosis rate of breast masses.展开更多
Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention...Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention. Although moderately sensitive, it is a highly specific staging strategy that is rarely falsely-positive, hence a positive UNB allows patients to be triaged to axillary lymph-node dissection(ALND) avoiding potentially unnecessary sentinel node biopsy(SNB). In this review, we extend our previous work through an updated literature search, focusing on studies that report data on UNB utility. Based on data for 10,934 breast cancer patients, sourced from 35 studies, a positive UNB allowed triage of 1,745 cases(simple proportion 16%) to axillary surgical treatment: the utility of UNB was a median 19.8% [interquartile range(IQR) 11.6%-26.7%] across these studies. We also modelled data from a subgroup of studies, and estimated that amongst patients with metastases to axillary nodes, the odds ratio(OR) for high nodal disease burden for a positive UNB versus a negative UNB was 4.38 [95% confidence interval(95% CI): 3.13, 6.13], P<0.001. From this model, the estimated proportion with high nodal disease burden was 58.9%(95% CI: 50.2%, 67.0%) for a positive UNB, whereas the estimated proportion with high nodal disease burden was 24.6%(95% CI: 17.7%, 33.2%) if UNB was negative. Overall, axillary UNB has good clinical utility and a positive UNB can effectively triage to ALND. However, the evolving landscape of axillary surgical treatment means that UNB will have relatively less utility where surgeons have modified their practice to omission of ALND for minimal nodal metastatic disease.展开更多
OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data ...OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data and pathological results of 235 pa-tients with breast lesions, who received CNB before surgery, wereanalyzed and compared. Based on the results of CNB done beforesurgery, 87 out of 204 patients diagnosed as invasive carcinomawere subjected to immunodetection for p53, c-erbB-2, ER and PR.The morphological change of cancer tissues in response to chemo-therapy was also evaluated.RESULTS In total of 235 cases receiving CNB examination, 204were diagnosed as invasive carcinoma, reaching a 100% consistentrate with the surgical diagnosis. Sixty percent of the cases diag-nosed as non-invasive carcinoma by CNB was identified to havethe presence of invading elements in surgical specimens, and simi-larly, 50% of the cases diagnosed as atypical ductal hyperplasia byCNB was confirmed to be carcinoma by the subsequent result ofexcision biopsy. There was no significant difference between theCNB biopsy and regular surgical samples in positive rate of im-munohistochemistry analysis (p53, c-erbB-2, ER and PR; P >0.05).However, there was significant difference in the expression rate ofp53 and c-erbB-2 between the cases with and without morphologi-cal change in response to chemotherapy (P < 0.05). In most caseswith p53 and c-erbB-2 positive, there was no obvious morphologi-cal change after chemotherapy.CONCLUSION CNB is a cost-effective diagnostic method withminimal invasion for breast lesions, although it still has some limi-tations. Immunodetection on CNB tissue is expected to have greatsignificance in clinical applications.展开更多
Objective： To investigate the value of the plasma transforming growth factor β1 （TGF-β1） level in diagnosis and prognosis of prostate cancer （PCa）. Methods： The ELISA kits for human TGF-β1 were used to measur...Objective： To investigate the value of the plasma transforming growth factor β1 （TGF-β1） level in diagnosis and prognosis of prostate cancer （PCa）. Methods： The ELISA kits for human TGF-β1 were used to measure the TGF-β1 level in plasmas. A cohort of 295 consecutive PCa patients in recent more than two years in the First Hospital of Peking University of China was enrolled to the study. Furthermore, 55 control subjects were healthy and without evidence of PCa, who were random people that came to the hospital and were identified by prostate biopsy. Results： An age-related frequency chart indicated that 99% confidence interval of the difference with PCa was at the age of 53-85 years. The PCa patients aged 53-85 were classified into three groups according to TNM staging. Group A had Stages TO, T1 and T2. Group B had Stage T3 and Group C had Stage T4. Compared with control group, Group A had the lower level of plasma TGF-β1 （P 〈 0.05）, Group B had the higher level of plasma TGF-β1 （P 〈 0.05） and Group C had the even higher level of plasma TGF-β1 （P 〈 0.01）. According to TNM staging, Group D had Stages TO, T1 and T2 with the normal level of total PSA （tPSA）. Group E with the normal level of tPSA had metastasis after resection. Compared with control group, Group D had the lower plasma level of TGF-β1 （P 〈0.05） and Group E had higher plasma level of TGF-β1 （P 〈 0.01）. Conclusion： The plasma TGF-β1 level decreases at early stage of PCa and increases at later stage of PCa, especially at tumor metastasis after the resection. The plasma TGF-β1 level may therefore be complementary to PSA for PCa prognosis.展开更多
Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for...Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods： In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45~ angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontally inwardly inclined 45~. Results： A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8% （8/45）, and prostate intraepithelial neoplasm （PIN） was 6.7% （3/45）. The pa- tients receiving repeat transrectal prostate biopsies were pathologically diagnosed as lower Gleason grade prostate cancers. Conclusion： The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrecta~ prostate biopsies patients.展开更多
Background:Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy.Many studies have sh...Background:Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy.Many studies have shown that rapid on-site evaluation(ROSE)improves diagnostic yield by 10–30%;however,more recent studies have demonstrated effective diagnostic accuracy rates without ROSE.Our study aims to examine whether the current standard of performing ROSE after each FNA pass adds diagnostic value during EUS-guided FNA of pancreatic masses.Methods:We conducted a retrospective case series on patients who underwent EUS-guided FNA of pancreatic masses between February 2011 and October 2014.All cases were performed by one of three endoscopists at Emory University Hospital.Patient demographics,radiologic details of pancreatic masses and pathology reports of the biopsied pancreatic masses were examined.Results:A total of 184 procedures performed in 171 patients were reviewed.The final pathology reports of the biopsied pancreatic masses showed 128(70%)with confirmed malignancy.Only 64(50%)of these 128 cases initially showed malignant cells during ROSE.Among these 64 cases,23%required 5 or more FNA passes to first detect malignant cells.Conclusions:The use of ROSE during EUS-guided FNA of pancreatic masses may increase the diagnostic yield,since malignant cells were often detected during later FNA passes that would otherwise be missed if tissue sampling stopped prematurely.In addition,sample preparation for ROSE may be suboptimal,since malignant cells were only detected in 50%of cases.展开更多
Objective To study the effects of 1% tetracaine hydrochloride jelly for pain control of patients receiving transrectal ultrasound （TRUS）-guided prostate biopsy. Methods A total of 100 patients receiving TRUS-guided ...Objective To study the effects of 1% tetracaine hydrochloride jelly for pain control of patients receiving transrectal ultrasound （TRUS）-guided prostate biopsy. Methods A total of 100 patients receiving TRUS-guided prostate biopsy were divided into two groups with 50 in each. In Group 1, patients received liquid paraffin, and in Group 2, patients were given 1% tetracaine hydrochloride jelly before biopsy. Pain score was measured by horizontal visual analogue scales （ VAS ）, and pain and discomfort were compared between the two groups. Results The average pain scores at the time of insertion of the ultrasound probe were 2. 9 ＋_1. 7 and 1. 4 ＋_1. 8 （ P =0. 000） and the average pain scores at the time of performing biopsy were 5. 2 ＋-1. 5 and 3. 1 ＋ 1. 7 （P =0. 000） in Group 1 and Group 2, respectively. There were no significant differences between the two groups in terms of age, serum prostate specific antigen, digital rectal examination, TRUS, and biopsy core number （ P 〉 O. 05 ）. There were no significant differences of complications after biopsy, such as hematuria, acute urinary retention, urinary tract infection, rectum bleeding, and fever （ P 〉0. 05）. Conclusion TRUS-guided prostate biopsy is safe. Use of 1% tetracaine hydrochloride jelly in the rectum and anus before TRUS-guided prostate biopsy is an effective method for relieving TRUS-guided prostate biopsy-induced pain during the procedure.展开更多
文摘Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound(TRUS)-guided multiple biopsy of the prostate,but is usually mild and stops spontaneously.We report what is believed to be the first case of life-threatening rectal bleeding following this procedure,which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding.This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy.Additionally,current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure,are described.
基金Supported by Medical University of South Carolina,United States
文摘Squamous cell carcinoma of the pancreas has been sparsely described since the 1940s,and generally has a poor prognosis.Herein,we present a case of primary squamous cell carcinoma of the pancreas with liver metastasis,both confirmed by endoscopic ultrasoundguided fine needle aspiration(EUS-FNA).To the best of our knowledge,this is the first case report in literature utilizing EUS-FNA for a cell-type specific diagnosis of primary pancreatic squamous cell carcinoma with a liver metastasis.
基金Supported by The Research Committee of Intractable Pancreatic Diseases provided by the Ministry of Health,Labour,and Welfare of Japan
文摘AIM:To investigate the usefulness of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA) in the differentiation of autoimmune pancreatitis(AIP).METHODS:We retrospectively reviewed 47 of 56 AIP patients who underwent EUS-FNA and met the Asian diagnostic criteria.On 47 EUS-FNA specimens,we evaluated the presence of adequate material and characteristic features of lymphoplasmacytic sclerosing pancreatitis(LPSP) and idiopathic duct-centric pancreatitis(IDCP) mentioned in the International Consensus Diagnostic Criteria and examined if these findings make a contribution to the differential diagnosis of type 1 and type 2 AIP.A disposable 22-gauge needle was used for EUS-FNA.RESULTS:Adequate specimens including pancreatic tissue for differentiating AIP from cancer were obtained from 43 of 47 patients who underwent EUSFNA.EUS-FNA was performed from the pancreatic head in 21 cases,which is known to be technically difficult when performed by core biopsy;there was no significant difference in the results compared with pancreatic body-tail.Nine of 47 patients met level 1 findings of LPSP and 5 patients met level 2 findings of LPSP.No one met level 1 findings of IDCP,but 3 patients met level 2 findings of IDCP.Of 10 seronegative cases,2 cases were diagnosed with "definitive type 1 AIP",and 3 cases were diagnosed with "probable type 2 AIP" when considering both the level 2 histological findings and response to steroids.CONCLUSION:EUS-FNA is useful in the differentiation of type 1 and type 2 AIP,particularly in seronegative cases.
文摘Objective: To evaluate the accuracy of these two methods and focus on the analysis and management of the false-negative cases. Methods: Results of full field digital mammography (FFDM) and fine needle aspiration cytology (FNAC) were obtained and analyzed from a consecutive of 102 women with palpable breast masses, results were correlated with the histopathological findings. Results: Of the 102 cases, malignancy was confirmed in 43 cases (42.16%) by final pathological examination, the sensitivity and specificity of cancer detection with FNA cytology was 90.7% (39/43) and 89.8% (53/59), re- spectively, the whole accuracy was 90.2% (92/102), with a positive predictive value of 86.7% (39/45) and a negative predictive value of 93.0% (53/57). FFDM gave a sensitivity of 88.4% (38/43), specificity of 83.1% (49/59), and whole accuracy 85.3% (87/102), the positive predictive value and negative predictive value was 79.2% (38/48) and 90.7% (49/54), respectively. All the FNAC-negative cancer cases were suggestive of malignancy by FFDM findings, however, the benign cases which present as equivocal finding by FNA cytology, could not be ruled out the presence of malignancy. Conclusion: FNAC and FFDM both are accurate, effective and economical diagnostic modalities, combined use of these two methods can reduced the misdiag- nosis rate of breast masses.
基金partly funded by National Health and Medical Research Council (NHMRC) program (Grant No. 633003) to the Screening & Test Evaluation Program, Australia
文摘Preoperative staging of the axilla in women with invasive breast cancer using ultrasound-guided needle biopsy(UNB) identifies approximately 50% of patients with axillary nodal metastases prior to surgical intervention. Although moderately sensitive, it is a highly specific staging strategy that is rarely falsely-positive, hence a positive UNB allows patients to be triaged to axillary lymph-node dissection(ALND) avoiding potentially unnecessary sentinel node biopsy(SNB). In this review, we extend our previous work through an updated literature search, focusing on studies that report data on UNB utility. Based on data for 10,934 breast cancer patients, sourced from 35 studies, a positive UNB allowed triage of 1,745 cases(simple proportion 16%) to axillary surgical treatment: the utility of UNB was a median 19.8% [interquartile range(IQR) 11.6%-26.7%] across these studies. We also modelled data from a subgroup of studies, and estimated that amongst patients with metastases to axillary nodes, the odds ratio(OR) for high nodal disease burden for a positive UNB versus a negative UNB was 4.38 [95% confidence interval(95% CI): 3.13, 6.13], P<0.001. From this model, the estimated proportion with high nodal disease burden was 58.9%(95% CI: 50.2%, 67.0%) for a positive UNB, whereas the estimated proportion with high nodal disease burden was 24.6%(95% CI: 17.7%, 33.2%) if UNB was negative. Overall, axillary UNB has good clinical utility and a positive UNB can effectively triage to ALND. However, the evolving landscape of axillary surgical treatment means that UNB will have relatively less utility where surgeons have modified their practice to omission of ALND for minimal nodal metastatic disease.
文摘OBJECTIVE To evaluate core needle biopsy (CNB) as a mini-mally invasive method to examine breast lesions and discuss theclinical significance of subsequent immunohistochemistry (IHC)analysis.METHODS The clinical data and pathological results of 235 pa-tients with breast lesions, who received CNB before surgery, wereanalyzed and compared. Based on the results of CNB done beforesurgery, 87 out of 204 patients diagnosed as invasive carcinomawere subjected to immunodetection for p53, c-erbB-2, ER and PR.The morphological change of cancer tissues in response to chemo-therapy was also evaluated.RESULTS In total of 235 cases receiving CNB examination, 204were diagnosed as invasive carcinoma, reaching a 100% consistentrate with the surgical diagnosis. Sixty percent of the cases diag-nosed as non-invasive carcinoma by CNB was identified to havethe presence of invading elements in surgical specimens, and simi-larly, 50% of the cases diagnosed as atypical ductal hyperplasia byCNB was confirmed to be carcinoma by the subsequent result ofexcision biopsy. There was no significant difference between theCNB biopsy and regular surgical samples in positive rate of im-munohistochemistry analysis (p53, c-erbB-2, ER and PR; P >0.05).However, there was significant difference in the expression rate ofp53 and c-erbB-2 between the cases with and without morphologi-cal change in response to chemotherapy (P < 0.05). In most caseswith p53 and c-erbB-2 positive, there was no obvious morphologi-cal change after chemotherapy.CONCLUSION CNB is a cost-effective diagnostic method withminimal invasion for breast lesions, although it still has some limi-tations. Immunodetection on CNB tissue is expected to have greatsignificance in clinical applications.
文摘Objective： To investigate the value of the plasma transforming growth factor β1 （TGF-β1） level in diagnosis and prognosis of prostate cancer （PCa）. Methods： The ELISA kits for human TGF-β1 were used to measure the TGF-β1 level in plasmas. A cohort of 295 consecutive PCa patients in recent more than two years in the First Hospital of Peking University of China was enrolled to the study. Furthermore, 55 control subjects were healthy and without evidence of PCa, who were random people that came to the hospital and were identified by prostate biopsy. Results： An age-related frequency chart indicated that 99% confidence interval of the difference with PCa was at the age of 53-85 years. The PCa patients aged 53-85 were classified into three groups according to TNM staging. Group A had Stages TO, T1 and T2. Group B had Stage T3 and Group C had Stage T4. Compared with control group, Group A had the lower level of plasma TGF-β1 （P 〈 0.05）, Group B had the higher level of plasma TGF-β1 （P 〈 0.05） and Group C had the even higher level of plasma TGF-β1 （P 〈 0.01）. According to TNM staging, Group D had Stages TO, T1 and T2 with the normal level of total PSA （tPSA）. Group E with the normal level of tPSA had metastasis after resection. Compared with control group, Group D had the lower plasma level of TGF-β1 （P 〈0.05） and Group E had higher plasma level of TGF-β1 （P 〈 0.01）. Conclusion： The plasma TGF-β1 level decreases at early stage of PCa and increases at later stage of PCa, especially at tumor metastasis after the resection. The plasma TGF-β1 level may therefore be complementary to PSA for PCa prognosis.
基金Supported by grants from the Pudong New Area Medical Health System Outstanding Young Talent Training Plan(No.PWRq2013-17)Zhoupu Hospital of Pudong New District(No.ZP-XM-2012B-22)
文摘Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods： In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45~ angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontally inwardly inclined 45~. Results： A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8% （8/45）, and prostate intraepithelial neoplasm （PIN） was 6.7% （3/45）. The pa- tients receiving repeat transrectal prostate biopsies were pathologically diagnosed as lower Gleason grade prostate cancers. Conclusion： The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrecta~ prostate biopsies patients.
文摘Background:Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)has become the preferred method to diagnose pancreatic masses due to its minimally invasive approach and diagnostic accuracy.Many studies have shown that rapid on-site evaluation(ROSE)improves diagnostic yield by 10–30%;however,more recent studies have demonstrated effective diagnostic accuracy rates without ROSE.Our study aims to examine whether the current standard of performing ROSE after each FNA pass adds diagnostic value during EUS-guided FNA of pancreatic masses.Methods:We conducted a retrospective case series on patients who underwent EUS-guided FNA of pancreatic masses between February 2011 and October 2014.All cases were performed by one of three endoscopists at Emory University Hospital.Patient demographics,radiologic details of pancreatic masses and pathology reports of the biopsied pancreatic masses were examined.Results:A total of 184 procedures performed in 171 patients were reviewed.The final pathology reports of the biopsied pancreatic masses showed 128(70%)with confirmed malignancy.Only 64(50%)of these 128 cases initially showed malignant cells during ROSE.Among these 64 cases,23%required 5 or more FNA passes to first detect malignant cells.Conclusions:The use of ROSE during EUS-guided FNA of pancreatic masses may increase the diagnostic yield,since malignant cells were often detected during later FNA passes that would otherwise be missed if tissue sampling stopped prematurely.In addition,sample preparation for ROSE may be suboptimal,since malignant cells were only detected in 50%of cases.
文摘Objective To study the effects of 1% tetracaine hydrochloride jelly for pain control of patients receiving transrectal ultrasound （TRUS）-guided prostate biopsy. Methods A total of 100 patients receiving TRUS-guided prostate biopsy were divided into two groups with 50 in each. In Group 1, patients received liquid paraffin, and in Group 2, patients were given 1% tetracaine hydrochloride jelly before biopsy. Pain score was measured by horizontal visual analogue scales （ VAS ）, and pain and discomfort were compared between the two groups. Results The average pain scores at the time of insertion of the ultrasound probe were 2. 9 ＋_1. 7 and 1. 4 ＋_1. 8 （ P =0. 000） and the average pain scores at the time of performing biopsy were 5. 2 ＋-1. 5 and 3. 1 ＋ 1. 7 （P =0. 000） in Group 1 and Group 2, respectively. There were no significant differences between the two groups in terms of age, serum prostate specific antigen, digital rectal examination, TRUS, and biopsy core number （ P 〉 O. 05 ）. There were no significant differences of complications after biopsy, such as hematuria, acute urinary retention, urinary tract infection, rectum bleeding, and fever （ P 〉0. 05）. Conclusion TRUS-guided prostate biopsy is safe. Use of 1% tetracaine hydrochloride jelly in the rectum and anus before TRUS-guided prostate biopsy is an effective method for relieving TRUS-guided prostate biopsy-induced pain during the procedure.
