抄録
Fine-needle aspiration biopsy (FNAB) guided by color Doppler-endoscopic ultrasonography (CD-EUS) was performed in 35 patients with gastric submucosal, pancreatic, bile-ductal lesions and lymph node swellings using linear scanning endoscopic ultrasonography. We investigated the success rate of biopsy for pathological or cytological analysis, accuracy rate and complications. The mean number of biopsy sessions was 2.3±1.1. The final diagnoses of gastric submucosal lesions were leiomyoma in 3, leiomyosarcoma in 2 and cysts in the gastric wall in 2 cases. The biopsy success rates were 66.7%, 100% and 100% in the leiomyoma, leiomyosarcoma and gastric wall cyst patients, respectively, and the overall success rate was 85.7%. All accuracy rates were 100%. The final diagnoses of pancreatic lesions were chronic pancreatitis in 7, pancreatic cysts in 10 (pseudocyst 4, retention cyst 4, intraductal papillary adenocarcinoma 1 and ductal carcinoma with cyst formation and invasive ductal carcinoma in 7 cases, and the biopsy success rates were 71.4%, 90.0% and 85.7%, respectively, with an overall success rate of 83.3%. The accuracy rates were 100%, 100% and 66.7% in pancreatitis, pancreatic cyst and ductal carcinoma patients, respectively, and the overall accuracy rate was 90%. A bile-ductal lesion was diagnosed as chronic choledochitis in 1 case, and the success and accuracy rates were both 100%. The final diagnoses of lymph node swellings were metastasis of gastric carcinoma in 1 and reactive change in 2 cases. The success rate was 66.7% and the accuracy rate was 100%. No severe complication was encountered except for one case of pancreatic enzyme elevation after cystography. In the follow-up period of 4 to 18 months, no seeding of malignant cells was observed. In conclusion, FNAB guided by CD-EUS increases the accuracy rate of CD-EUS diagnosis for lesions around the gastrointestinal tract without any severe complications. The indication for malignant tumor should be considered after determination of the seeding rate.
