EUS-FNA对消化道壁外占位性病变的诊断价值

发布时间：2018-02-27 08:48

  本文关键词： 超声内镜 细针穿刺活检 消化道壁外占位性病变 诊断 并发症　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:探讨超声内镜引导下细针穿刺活检(EUS-FNA)对消化道壁外占位性病变的诊断价值。方法:通过检索河北医科大学第二医院消化内镜室数据库,筛选出自2014年6月至2016年12月行超声内镜引导下细针穿刺活检术的患者22例。这些患者均为经B超、CT或MRI检查可疑消化道壁外占位性病变(包括胰腺、纵膈、腹腔)的住院患者。其中,男12例,女10例,年龄34-81岁。纵膈占位8例、胰腺占位13例(实性占位11例,囊性占位2例)、腹腔占位1例。患者的穿刺样本送组织病理学、液基细胞学或病理涂片检查。可疑结核病变的送抗酸染色和TB-DNA检查。胰腺囊性病变所得囊液送CA-199、CEA及CA-125检测。追踪患者术后的病理结果、并发症的发生、后续的治疗及转归情况。结果:1 EUS-FNA作为消化道壁外占位性病变的诊断方法,安全、成功率高,并发症少见。2 EUS-FNA鉴别消化道壁外占位性病变良恶性的总体灵敏度、特异度、阳性预测值、阴性预测值及准确率分别为:88.9%、100%、100%、66.7%、90.9%。3 EUS-FNA的穿刺次数≥3次与3次的诊断准确性一致。EUS-FNA在胰腺和纵膈的诊断准确性一致。4 EUS-FNA的标本行组织病理学、液基细胞学及病理涂片的诊断准确性一致。结论:EUS-FNA在鉴别消化道壁外占位性病变良恶性上是一种安全、有效且准确的方法,并发症少见。穿刺针数、部位、标本处理方法对其诊断准确性上无明显影响。
[Abstract]:Objective: to investigate the diagnostic value of EUS-FNA-guided endoscopic fine needle biopsy in the diagnosis of extramural space occupying lesions of digestive tract. Methods: the database of digestive endoscopy room in the second Hospital of Hebei Medical University was searched. From June 2014 to December 2016, 22 patients undergoing endoscopic fine needle biopsy were selected. These patients were examined by B-ultrasound CT or MRI for suspected extramural lesions of the digestive tract (including pancreas, mediastinum, mediastinum, pancreas, mediastinum). There were 12 males and 10 females aged 34-81 years, 8 cases with mediastinal mass, 13 cases with pancreatic mass (11 cases with solid space occupying, 2 cases with cystic space occupying, 1 case with abdominal space occupying). Fluid based cytology or pathological smear examination. Acid-fast staining and TB-DNA examination of suspected tuberculosis. Cystic fluid from pancreatic cystic lesions were sent to CA-199C CEA and CA-125. The pathological results and complications of the patients were followed up. Results: as a diagnostic method for extramural space occupying lesions of the digestive tract, 1: 1 EUS-FNA was safe and had a high success rate. The total sensitivity and specificity of 2. 2 EUS-FNA in differentiating benign and malignant lesions were rare. The positive predictive value, the negative predictive value and the accuracy were 88.9% and 66.7%, respectively. The accuracy of the puncture times of 90.9.3 EUS-FNA 鈮，

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