Diagnostic Value And Clinical Application Of Endoscopic Ultrasound Guided Fine-needle Aspiration Biopsy In Upper Gastrointestinal Wall And Extramural Space Occupying Lesions

Objective: To retrospectively analyze the clinical characteristics of cases undergoing endoscopic ultrasound guided fine-needle biopsy,and to explore the diagnostic value and clinical application of endoscopic ultrasound guided fine-needle biopsy in upper gastrointestinal wall and extramural space occupying lesions.Methods:Collect general clinical data,endoscopic ultrasound data,endoscopic ultrasound pathology,and postoperative pathological diagnosis results of patients who underwent endoscopic ultrasound guided fine needle biopsy at our hospital’s endoscopy center from January 1,2016 to December 31,2021,and include eligible patients through inclusion criteria,And through statistical comparison and analysis of the diagnostic rates of conventional examination methods(such as transabdominal ultrasound,CT,MRI,gastroscopy,etc.)combined with endoscopic ultrasound guided fine needle aspiration biopsy(EUS-FNA);Through statistical analysis of ultrasound endoscopy combined with auxiliary research methods such as immunohistochemistry and liquid based cytology,the diagnostic rate can be improved;Statistical analysis of the diagnostic efficacy of endoscopic ultrasound guided fine-needle aspiration biopsy at different sites;Review the endoscopic ultrasound data of patients diagnosed with pancreatic tumors through pathological examination,and statistically analyze the possible reasons for false negative puncture results in pancreatic tumor lesions.Results: A total of 80 patients were included through inclusion and exclusion criteria,including 42 males and 38 females.Endoscopic ultrasound guided fine needle aspiration biopsy(EUS-FNA)was performed in the diagnosis of upper gastrointestinal wall and extramural space occupying lesions.Compared with other traditional examination techniques such as ultrasound,CT,MRI,and gastroenteroscopy,the P values of gastric wall and perigastric wall lesions,mediastinal lesions,pancreas,and other intra-abdominal extraluminal lesions of the upper gastrointestinal tract were all<0.05,The difference is statistically significant.At the same time,when fine needle aspiration biopsy under ultrasound endoscopy was further combined with auxiliary studies such as immunohistochemistry,the diagnostic accuracy of the esophageal group was50.00%,the diagnostic accuracy of gastric and perigastric lesions was 70.00%,and the diagnostic accuracy of mediastinal lesions was 100.00%.In the pancreatic group,when combined with immunohistochemistry and liquid based cytology,the diagnostic accuracy was 80.85%.In other abdominal space occupying lesions,when combined with immunohistochemistry and liquid based cytology,the diagnostic accuracy was 80.85%,The diagnostic accuracy is 100.00%.Calculate the diagnostic efficacy of fine needle biopsy under endoscopic ultrasound for different sites.The sensitivity and specificity of mediastinal mass group were100.00% and 100.00%,respectively.The sensitivity and specificity of gastric and perigastric mass group were 57.14% and 100.00%,respectively.The sensitivity and specificity of pancreatic mass group were 75.00% and 100.00%,respectively.Overall,the sensitivity and specificity of extraluminal space occupying lesions in the upper gastrointestinal tract in this study were 77.97% and 95.24%,respectively.At the same time,a study was conducted on the factors that may cause false negative puncture results in pancreatic tumor lesions.It was found that factors such as lesion size,puncture frequency,cystic lesions,the proportion of cystic solid lesions,and whether local inflammatory reactions were present were studied,and the differences were not statistically significant.Conclusion: Endoscopic ultrasound guided fine needle aspiration biopsy has important diagnostic value in the diagnosis of upper gastrointestinal wall and extramural space occupying lesions.Meanwhile,compared with other traditional examination techniques such as B-ultrasound,CT,MRI,and gastroscopy,endoscopic ultrasound guided fine needle aspiration biopsy has better sensitivity and specificity in diagnosis.