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首页> 外文期刊>Surgical Endoscopy >EUS-guided Trucut needle biopsies as first-line diagnostic method for patients with intestinal or extraintestinal mass lesions.
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EUS-guided Trucut needle biopsies as first-line diagnostic method for patients with intestinal or extraintestinal mass lesions.

机译：EUS指导的Trucut穿刺活检是肠或肠外肿块患者的一线诊断方法。

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INTRODUCTION: Fine-needle aspiration (FNA) is a well-established technique to obtain cytological specimens, but it does not permit the extraction of histological tissue-core samples, which, if available, may increase the yield and accuracy of the histopathological diagnosis. This prospective study was designed to assess the yield and diagnostic accuracy of endoscopic ultrasound (EUS)-guided Trucut needle biopsy (TNB) as first-line diagnostic method for suspected malignant lesions identified by upper gastrointestinal EUS. METHODS: In a prospective case series, 24 consecutive patients (14 women; median age, 68 (range, 38-84) years) with suspected malignancy underwent EUS-TNB with a 19-gauge needle. EUS was performed with a linear scanning echo endoscope. When the EUS-TNB device did not collect adequate samples, subsequent EUS-FNA was performed. The presence or absence of malignancy was confirmed by postoperative histopathology or diagnostic imaging follow-up for at least 9 months. RESULTS: Adequate tissue specimens were obtained in 20 of 24 (83%) patients by TNB. An accurate diagnosis was achieved in 19 of 20 (95%) patients in whom TNB was successful with a sensitivity and specificity of 93% and 100%, respectively. In 11 patients malignant disease was found, whereas 8 patients showed benign lesions on TNB-obtained histopathology. Thirteen patients underwent additional EUS-FNA. The diagnosis by TNB was confirmed in seven of nine (78%) patients with additional FNA. In three of four patients with inadequate TNB, the diagnosis was established by FNA. The overall accuracy of EUS-TNB was 79% (19/24) for all patients and 92% (22/24) with subsequent FNA. The positive and negative predictive values for the diagnosis of a malignant lesion by EUS-TNB were 57.9% and 88.9%, respectively. Neither method had any procedure-related complications. CONCLUSIONS: EUS-guided TNB is a safe and accurate technique to obtain core specimen for histopathologic diagnosis in patients with suspected malignancies on upper gastrointestinal EUS. FNA can serve as rescue technique and should be performed if TNB fails to obtain adequate tissue samples.
机译：简介：细针穿刺术（FNA）是一种获得细胞学标本的成熟技术，但它不允许提取组织学核心样品，如果可以的话，可以提高组织病理学诊断的产率和准确性。这项前瞻性研究旨在评估内镜超声（EUS）引导的Trucut针穿刺活检（TNB）作为上消化道EUS鉴别出的可疑恶性病变的一线诊断方法的准确性。方法：在一个前瞻性病例系列中，使用19号针头对EUS-TNB进行连续24例怀疑恶性肿瘤的患者（14名女性;中位年龄68岁（范围38-84岁））。 EUS用线性扫描回波内窥镜进行。当EUS-TNB设备未收集到足够的样本时，将执行后续的EUS-FNA。术后至少9个月的术后组织病理学或诊断性影像学检查证实了恶性肿瘤的存在与否。结果：TNB在24名患者中有20名（83％）获得了足够的组织标本。在20例TNB成功的患者中，有19例（95％）获得了准确的诊断，其敏感性和特异性分别为93％和100％。在11例患者中发现了恶性疾病，而8例患者在TNB获得的组织病理学上显示出良性病变。 13名患者接受了额外的EUS-FNA。在9名（78％）患有FNA的患者中有7名证实了TNB的诊断。 TNA不足的四名患者中有三名是由FNA确定的。对于所有患者，EUS-TNB的总体准确性为79％（19/24），随后进行FNA的总体准确性为92％（22/24）。 EUS-TNB诊断恶性病变的阳性和阴性预测值分别为57.9％和88.9％。两种方法都没有任何与手术相关的并发症。结论：EUS引导的TNB是一种安全，准确的技术，可用于上消化道EUS怀疑为恶性肿瘤的患者获取用于组织病理学诊断的核心标本。 FNA可以用作救援技术，如果TNB无法获得足够的组织样本，则应执行FNA。

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