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Accuracy and Quality Assessment of EUS-FNA: A Single-Center Large Cohort of Biopsies

机译：EUS-FNA的准确性和质量评估：单中心活检大型队列

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Introduction. Thorough quality control (QC) study with systemic monitoring and evaluation is crucial to optimizing the effectiveness of EUS-FNA.Methods. Retrospective analysis was composed of investigating consecutive patient files that underwent EUS-FNA. QC specifically focused on diagnostic accuracy, impacts on preexisting diagnoses, and case management.Results. 268 patient files were evaluated. EUS-FNA cytology helped establish accurate diagnoses in 92.54% (248/268) of patients. Sensitivity, specificity, PPV, NPV, and accuracy were 83%, 100%, 100%, 91.6%, and 94%, respectively. The most common biopsy site was the pancreas (68%). The most accurate location for EUS-FNA was the esophagus, 13/13 (100%), followed by the pancreas (89.6%). EUS-FNA was least informative for abdominal lymph nodes (70.5%). After FNA and followup, eight false negatives for tumors were found (3%), while 7.5% of samples still lacked a definitive diagnosis.Discussion. QC suggests that the diagnostic accuracy of EUS-FNA might be improved further by (1) taking more FNA passes from suspected lesions, (2) optimizing needle selection (3) having an experienced echo-endoscopist available during the learning curve, and (4) having a cytologist present during the procedure. QC also identified remediable reporting errors. In conclusion, QC study is valuable in identifying weaknesses and thereby augmenting the effectiveness of EUS-FNA.
机译：介绍。全面的质量控制（QC）研究以及系统的监控和评估对于优化EUS-FNA的有效性至关重要。回顾性分析由调查接受EUS-FNA的连续患者档案组成。质量控制特别关注诊断准确性，对先前诊断的影响以及病例管理。评估了268个患者档案。 EUS-FNA细胞学有助于对92.54％（248/268）的患者进行准确的诊断。敏感性，特异性，PPV，NPV和准确度分别为83％，100％，100％，91.6％和94％。最常见的活检部位是胰腺（68％）。 EUS-FNA最准确的位置是食道，为13/13（100％），其次是胰腺（89.6％）。 EUS-FNA对腹部淋巴结的信息最少（70.5％）。在FNA和随访之后，发现了8个肿瘤假阴性（3％），而7.5％的样品仍缺乏明确的诊断。 QC建议通过（1）从可疑病变中获取更多FNA通过，（2）优化选针（3）在学习曲线期间有经验丰富的回声内镜医师来进一步改善EUS-FNA的诊断准确性，以及（4） ）在手术过程中有细胞学家在场。质量控制还确定了可纠正的报告错误。总之，质量控制研究对于识别弱点，从而增强EUS-FNA的有效性非常有价值。

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