The Clinical Value Of Cell Block Method By EUS-FNA In Mediastinal Lesions

Objective:To investigate the clinical value of the cell block(CB) method byendoscopic ultrasound-guided fine-needle aspiration（EUS-FNA）biopsy formediastinal lesions.Methods:These study including24mediastinal lesions patients wererecruited in this study,who underwent EUS-FNA in the First AffiliatedHospital Of Guangxi Medical University from October2010to Augest2013.The EUS-FNA samples of all patients were processed by conventionalsmear cytology,liquid-based cytology(LBC)and cell block withimmunohistochemistry.All the pathologic results were tracked after EUS-FNA，the postoperative patients were follow-up for six month。Result:22mediastinal lesions patients were finally diagnosed.Amongthem,12cases were malignant lesions(10cases were lymph node metastasis inlung cancer,1case was neuroendocrine carcinoma,1case was lymphoma);10cases were Benign lesions (7cases were lymph node tuberculosis,1case wasmediastinalteratoma and pulmonary tuberculosis,1case was pulmonary diffuselymphangioma,1case was leiomyoma of esophagus).2patients were failed todiagnosed.22diagnosed pathologically patients were received clinical treatment immediately.2patients who didn’t diagnosed pathologically were receivedrelief or supportive treatment. Among all the24cases,20cases could made cellblock successfully. The diagnostic sensitivity of conventional smear cytology,liquid-based cytology and cell block were66.7%,75%,100%respectively. Theaccurate rate of the cell block was higher than that of the conventional smearcytology and the liquid-based cytology. No severe complications such aspostoperative infection,bleeding,andaerothorax occurred in these patients.Conclusion: EUS-FNA was a safe and effective method with highsensitivity and specificity in the diagnosis of mediastinallesions. Especially cellblock method combining immunohistochemistry may help to improve theaccurate diagnosis and have important clinical value in guiding the treatmentstrategy and judging the prognosis.