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首页> 外文期刊>Annals of diagnostic pathology >Endoscopic ultrasound-guided fine needle aspiration as a diagnostic and staging tool for rectal and perirectal lesions - An institutional experience
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Endoscopic ultrasound-guided fine needle aspiration as a diagnostic and staging tool for rectal and perirectal lesions - An institutional experience

机译：内窥镜超声引导下细针穿刺术作为直肠和直肠周围病变的诊断和分期工具-机构经验

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The role of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in evaluating lesions adjacent to the upper gastrointestinal tract wall is well established. However, this tool is underused in evaluating rectal and perirectal lesions, possibly due to insufficient experience and underrecognized value of this procedure. In this study, we report our institutional experience with EUS-FNA as a diagnostic and staging tool for rectal and perirectal lesions. A retrospective chart review was performed and a cohort of 38 patients who underwent rectal EUS-FNA (41 specimens) at our institution between January 2002 and July 2012 was retrieved. The cytology diagnoses were compared with the concurrent or follow-up histologic and clinical diagnoses. Among the total 41 cases, rectal EUS-FNA was performed as a diagnostic procedure in 22 (54%) and a staging procedure in 19 (46%) cases. On cytology examination, 18 cases (44%) were diagnosed as malignant; 1 (2%), as atypical/suspicious for malignancy; 3 (7%), as benign neoplastic; 13 (32%), as nonneoplastic; and 6 (15%), as nondiagnostic cases. Concurrent or follow-up histologic diagnoses were available in 20 cases (48%), 19 of them had concordant cytological/histologic findings (10 benign, 9 malignant). One perirectal lymph node with negative cytology diagnosis was found to be positive on histologic examination, probably due to sampling error on cytology. The sensitivity and specificity of EUS-FNA for detecting malignant rectal/perirectal lesions in this study were 91% and 100%, respectively. Endoscopic ultrasound-guided fine needle aspiration is a useful diagnostic tool for rectal/perirectal lesions; it confirms or excludes malignancy for lesions with high or low clinical suspicions. It serves as a reliable staging method to identify patients for proper clinical management.
机译：内镜超声引导下细针穿刺抽吸术（EUS-FNA）在评估上消化道壁附近病变中的作用已得到充分确立。但是，该工具在评估直肠和直肠周围的病变方面未得到充分利用，可能是由于经验不足和对该方法的认识不足。在这项研究中，我们报告了EUS-FNA作为直肠和直肠周围病变的诊断和分期工具的机构经验。进行了回顾性图表审查，并检索了2002年1月至2012年7月间在我们机构接受直肠EUS-FNA（41个样本）的38例患者的队列。将细胞学诊断与同期或随访的组织学和临床诊断进行比较。在总共41例病例中，22例（54％）进行了直肠EUS-FNA诊断，19例（46％）进行了分期。在细胞学检查中，有18例（44％）被诊断为恶性。 1（2％），为非典型/可疑恶性肿瘤; 3（7％），为良性肿瘤; 13（32％），为非肿瘤性;非诊断病例为6例（15％）。同时或随访的组织学诊断为20例（48％），其中19例具有一致的细胞学/组织学发现（良性10例，恶性9例）。在组织学检查中发现一个细胞学诊断为阴性的直肠周围淋巴结阳性，这可能是由于细胞学上的采样错误所致。在这项研究中，EUS-FNA检测直肠/直肠周围病变的敏感性和特异性分别为91％和100％。内窥镜超声引导下细针穿刺术是诊断直肠/直肠周围病变的有用工具;它可确认或排除临床怀疑程度高或低的病变的恶性肿瘤。它是一种可靠的分期方法，可以识别患者以进行适当的临床治疗。

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