快速现场细胞学评估在西藏地区超声内镜细针穿刺诊断消化系占位中的初步应用

Preliminary application of rapid on‑site evaluation to the diagnosis of digestive space‑occupying lesions by endoscopic ultrasound‑guided fine needle aspiration in Xizang

摘要:

为探讨快速现场细胞学评估（rapid on‑site evaluation，ROSE）在超声内镜引导细针穿刺抽吸术（endoscopic ultrasound‑guided fine needle aspiration，EUS‑FNA）诊断消化系占位中的临床应用价值，回顾性分析2022年8月至2023年8月于拉萨市人民医院消化内镜中心因存在腹腔或消化道占位性病变行EUS‑FNA的患者14例，其中7例行EUS‑FNA联合ROSE，7例行单纯EUS‑FNA，比较两种方法穿刺与诊断情况以及并发症发生情况。所有患者操作过程顺利，术中、术后均未发生内镜操作相关的不良事件和并发症。行EUS‑FNA联合ROSE的患者穿刺（1.5±0.5）针，行单纯EUS‑FNA的患者穿刺（2.6±0.4）针，EUS‑FNA联合ROSE穿刺成功7例，单纯EUS‑FNA穿刺成功6例。行EUS‑FNA联合ROSE患者诊断结果与最终诊断相符6例，行单纯EUS‑FNA患者诊断结果与最终诊断相符5例 。ROSE技术操作简单便捷，可以减少EUS‑FNA穿刺次数，提高EUS‑FNA穿刺样本充分率以及诊断的准确性，值得进一步推广研究。

Abstract:

To explore the clinical application value of rapid on‑site evaluation (ROSE) in endoscopic ultrasound‑guided fine needle aspiration (EUS‑FNA) for the diagnosis of digestive system space‑occupying lesions, a retrospective analysis was conducted on 14 patients who underwent EUS‑FNA at the Digestive Endoscopy Center of Lhasa People""s Hospital from August 2022 to August 2023 due to abdominal or digestive tract space‑occupying lesions. Seven cases underwent EUS‑FNA combined with ROSE, and 7 cases underwent EUS‑FNA only. Puncture and diagnosis of the two methods and the occurrence of complications were compared. All patients received procedures smoothly, and no adverse events or complications related to endoscopic procedure occurred during or after the operation. Patients who performed EUS‑FNA combined with ROSE were punctured with 1.5±0.5 needles, and those who performed EUS‑FNA alone were punctured with 2.6±0.4 needles. EUS‑FNA combined with ROSE puncture was successful in 7 cases and EUS‑FNA alone was successful in 6 cases. Among the patients who underwent EUS‑FNA combined with ROSE, the diagnostic results were consistent with the final diagnosis in 6 cases, and in 5 cases who underwent EUS‑FNA alone. ROSE is simple and convenient to operate, can reduce the number of EUS‑FNA puncture, and improve the adequacy rate of EUS‑FNA puncture samples and diagnostic accuracy, which is worth of further promotion and research.