EUS-FNA Of Different Sampling Methods In The Diagnosis Of Solid Pancreatic Lesions

Objective : The effect of different sampling methods of EUS-FNA on the sample quality and diagnostic efficiency of solid pancreatic lesions be explored.Methods: A retrospective collection of patients with pancreatic space-occupying lesions in our hospital from January 2020 to December 2020 in the Affiliated Hospital of Qinghai University,and successfully performed EUS-FNA examinations.According to the inclusion and exclusion criteria,a total of 58 study subjects were included,including 28 males and 30 females,with an average age of 56.6±12.2 years.All EUSFNAs are completed by the same experienced endoscopy doctor.According to the different puncture sampling methods,the patients will be divided into dry needle aspiration technology group,wet needle aspiration technology group and heparin wet needle aspiration technology group.The samples are sent for histological and cytological pathological examination,and the final diagnosis is based on the pathological diagnosis after surgical treatment or the 6-month follow-up results after EUS-FNA examination.After the operation,the endoscopist recorded the operation process in detail,and compared the three puncture techniques in cell histology quality,cell smear blood staining,diagnostic sensitivity,specificity,PPV,NPV,The difference between the diagnostic accuracy rates.Result:Among 58 patients undergoing EUS-FNA examination,46 patients were diagnosed as malignant lesions,12 patients were diagnosed as benign lesions,and 2patients developed hyperamylaseemia after surgery.The adequacy rate of cytology samples obtained by dry needle aspiration technique,wet needle aspiration technique and heparin wet needle aspiration technique were 76.1%,84.2%,and 83.3%,respectively.The adequacy rate of cytology samples obtained by wet needle aspiration technique was slightly higher than the other The two techniques,but the difference is statistically significant;the sufficient rates of histological samples obtained are 57.1%,89.5%,and 88.9%,respectively,and the sufficient rates of histological samples of wet needle aspiration technique and heparin wet needle aspiration technique are higher than those of dry needle The difference in aspiration technique is statistically significant;the three sampling techniques have no significant difference in cell density classification(class A,B,C,D).The wet needle aspiration technique and the heparin wet needle aspiration technique are in The ratio of the cell density(A+B grade)obtained is higher than that of dry needle aspiration technique,and the difference is statistically significant;the ratio of tissue strip grade A grade of wet needle aspiration technique and heparin wet needle aspiration technique is significantly greater than The difference in dry needle aspiration technique was statistically significant.Compared with the degree of blood contamination of cell smears,there is no obvious difference between the three suction and sampling techniques;The diagnostic sensitivities of the three sampling techniques were 80.0%,88.2%,and 88.2%;the specificity and positive predictive value were 100%;the negative predictive value,was 55.6%,66.6%,and 60%;the diagnostic accuracy rates were 84.0%,90.5%,90.0%,the three sampling techniques showed no significant differences in diagnostic sensitivity,specificity,positive predictive value,negative predictive value and sample adequacy.Conclusion: EUS-FNA of different sampling methods In the diagnosis of solid pancreatic lesions,the wet needle aspiration technique and the heparin wet needle aspiration technique obtain a higher sufficient rate of tissue samples,and the quality of cytology and histology samples is better;the three sampling methods are in the cell There were no significant differences in the degree of blood contamination,diagnostic sensitivity,specificity,PPV,NPV,and diagnostic accuracy of the samples.