| Background and Objective:Endoscopic ultrasound-guided fine needle aspiration/biopsy is a combination of endoscopic and ultrasound techniques for the examination of the digestive tract,which is widely used in clinical practice,including the diagnosis of pancreatic space-occupying lesions,the differential diagnosis of subepithelial tumors of digestive tract,the diagnosis of unknown space-occupying lesions or enlarged lymph nodes in adjacent tissues of digestive tract,etc.But it’s the most widely used in the diagnosis of solid space occupying lesions of the pancreas and have high diagnostic value,safety,and low complication rates.The diagnosis of EUS-FNA / FNB has been found to be influenced by several factors,Including but not limited to needle type,lesion size,lesion location,etc.The study aimed to analyze the diagnostic value and associated factors of EUS-FNA / FNB for pancreatic,esophageal and gastric,mediastinal and lymph node,abdominal and retroperitoneal lesions,providing a certain theoretical basis for the clinical application of EUS-FNA / FNB.Materials and methods:Patients who were referred to the people’s Hospital of Henan University from 2019.01-2022.05 and who had gastrointestinal or extramural space occupying lesions suggested by CT,MRI or ultrasound were retrospectively collected,EUS-FNA / FNB was performed in 131 cases,83 males and 48 females;Years range 27-83 years,with a mean age(60.4 ± 11.9).They were divided into four groups according to the location of the lesion: pancreas(89 patients),esophagus and stomach(13 patients),mediastinum and lymph nodes(12 patients),abdominal cavity and retroperitoneum(11 patients).The samples obtained by puncture were sent for histological and cytological pathological examination,and the final diagnosis relied on pathological diagnosis after surgical treatment or 6-month follow-up results after EUS-FNA/FNB examination.And analyzing the effects of lesion location,size,nature of the lesion,and number of punctures on the diagnostic value of EUS-FNA / FNB.Results:EUS-FNA / FNB was performed in 131 patients,and adequate tissue was obtained for pathological diagnosis in 129 patients,resulting in a puncture success rate of 98.47%.The diagnostic sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of EUS-FNA / FNB in pancreatic space occupying lesions were 85.53%,90.91%,98.48%,47.62%,86.21%,respectively;The diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of esophageal and gastric lesions were 85.71%,100%,100%,33.33% and 86.67% respectively;The sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 92.31%,75%,92.31%,66.67% and 93.33%,respectively,in the diagnosis of mediastinal lymph node related lesions;The corresponding diagnostic sensitivity,positive predictive value,and accuracy were 54.55%,100%,54.55% for the diagnosis of celiac and retroperitoneal disease,respectively.The specificity and negative predictive value could not be calculated.Only one patient developed pancreatic fistula after puncture,and the complication rate was 0.76%.None of the patients had major complications including gastrointestinal bleeding,perforation,pancreatitis,or biliary fistula.There was a statistically significant difference between EUS-FNA / FNB in pancreatic lesions with respect to age,space size,and number of punctures(P<0.05),there were no significant differences in gender,nature,location or needle type(P>0.05);For lesions involving the esophagus and the stomach,EUS-FNA/FNB was statistically significant in patients of different ages and with different needle patterns(P<0.05),there was no statistical significance in patients of different gender,size or number of punctures(P>0.05);On the analysis of the factors affecting the diagnostic value of mediastinal and lymph node space occupying,there was no significant difference between EUS-FNA / FNB in patients with different age,gender,size,number of different punctures and the use of different needle patterns(P>0.05);For the analysis of factors affecting the diagnostic value of abdominal and retroperitoneal space occupying,EUS-FNA / FNB was statistically significant in patients with different space occupying size(P<0.05),but not in patients with different age,gender,number of different punctures and the use of different needle patterns(P>0.05).Conclusion:1.Eus-FNA/FNB has high diagnostic value for digestive tract and extra-mural diseases with high sensitivity,specificity,safety and low complication rate.2.In pancreatic lesions was mainly influenced by age,lesion size and number of punctures;For the diagnosis of oesophagus versus stomach,it was mainly influenced by age and needle type;For abdominal and retroperitoneal lesions diagnosis is mainly influenced by lesion size;For mediastinal and nodal disease,gender,age,lesion size,number of punctures,and needle type were less influential in diagnosis. |
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