The Value Of EUS-FNA In Extramural Lesions Of The Upper Gastrointestinal Tract

Objective:To evaluate significance of EUS-FNA in diagnosis extramural lesions of the upper gastrointestinal tract.Methods:EUS-FNA was performed in74(49men,25women) patients with pancreatic lesions, mediastinal and retroperitoneal masses detected by ultrasonography, CT or clinical suspected diagnosis,36of the74are pancreatic lesions,25are mediastinal masses, and13are retroperitoneal masses, cytological and pathological evaluation were performed, flow cytometry was performed when necessary. Three patients with advanced pancreatic cancer underwent celiac plexus neurolysis (CPN) for pain-relieving, three patients with EUS-guided pancreatic pseudocyst drainage.Result:(1) The overall diagnosis sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) accuracy of EUS-FNA were respectively82.6%,100%,100%,77.8%,89.2%.(2) Pancreatic lesions had lower NPV than other lesions.(3) The accuracy of EUS-FNA was not associated with mass size. More needle passes can enhance the diagnosis accuracy of EUS-FNA.(4) Three patients with advanced pancreatic cancer underwent celiac plexus neurolysis (CPN) were decreased in pain scores. The pain was relief in three patients with EUS-guided pancreatic pseudocyst drainage.Conclusion:EUS-FNA is a safe, accurate and successful procedure in the diagnosis extramural lesions of the upper gastrointestinal tract regardless its size, but more needle passes can enhance the diagnosis accuracy of EUS-FNA.