超声内镜引导细针穿刺抽吸术在常规内镜活检阴性食管狭窄病变中的诊断价值

Diagnostic value of endoscopic ultrasound‑guided fine needle aspiration for biopsy‑negative esophageal strictures

摘要:

目的 探讨超声内镜引导细针穿刺抽吸术（endoscopic ultrasound⁃guided fine needle aspiration，EUS⁃FNA）在常规内镜活检阴性食管狭窄病变中的诊断价值。方法 回顾性分析2014年1月至2022年3月在南京大学医学院附属鼓楼医院因常规内镜活检阴性行EUS⁃FNA的食管狭窄患者的资料，以穿刺或手术病理结果和随访情况作为最终诊断依据，评估EUS⁃FNA对此类病变的诊断效能，并观察术后并发症。结果 共纳入64例患者，最终诊断为54例恶性病变，10例良性病变。EUS‑FNA诊断恶性病变50例，可疑恶性病变3例，未见明确恶性依据11例。EUS⁃FNA诊断准确率为98.4%（63/64），EUS⁃FNA对恶性肿瘤的检出率为98.1%（53/54）。术后观察患者均未出现出血、穿孔、感染等并发症。结论 对常规内镜活检阴性但怀疑恶性病变的食管狭窄患者行EUS⁃FNA是一种安全有效的诊断方法，其恶性病变检出率高。

Abstract:

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for biopsy-negative esophageal strictures suspected for malignancy. Methods Patients who underwent EUS-FNA for esophageal strictures with negative endoscopic biopsies in Nanjing Drum Tower Hospital from January 2014 to March 2022 were analyzed retrospectively. The final diagnosis was based on the pathological outcomes of EUS-FNA or surgery, complemented by follow-up data. Diagnostic efficacy and complication rates of EUS-FNA were analyzed. Results A total of 64 patients were included in this study,with 54 ultimately diagnosed with malignant lesions and 10 with benign lesions. Malignant lesions were diagnosed by EUS-FNA in 50 cases, suspected malignant lesions in 3 cases, and no clear basis for malignancy was observed in 11 cases. The diagnostic accuracy of EUS-FNA was 98.4% (63/64), with the malignant tumor detection rate of 98.1% (53/54). No post-procedure complications such as bleeding, perforation, or infection were observed in any patient. Conclusion EUS-FNA is safe and effective for the diagnosis of biopsy-negative suspected malignant esophageal stricture with a high malignant lesion detection rate.