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KMID : 0359020130460060627
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Korean Journal of Gastrointestinal Endoscopy
2013 Volume.46 No. 6 p.627 ~ p.632
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Performance and Clinical Role of Endoscopic Ultrasound Fine Needle Aspiration for Diagnosing Gastrointestinal Intramural Lesions
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Sung Hae-Jung
Cho Yu-Kyung
Park Eun-Young
Moon Sung-Jin
Lim Chul-Hyun
Kim Jin-Su
Park Jae-Myung
Lee In-Seok
Kim Sang-Woo
Choi Myung-Gyu
Choi Gyu-Yong
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Abstract
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Background/Aims: We evaluated the performance, clinical role, and diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) in gastrointestinal intramural lesions.
Methods: Procedural and pathologic data were reviewed from consecutive patients undergoing EUS-FNA for intramural lesions. Final diagnoses were determined by surgical histopathologic conformation and the diagnosis of malignancy, including clinical follow-up with repeat imaging.
Results: Forty-six patients (mean age, 47 years; 24 males) underwent EUS-FNA. Lesions were located in the stomach (n=31), esophagus (n=5), and duodenum (n=10). The median lesion size was 2 cm (range, 1 to 20.6). Final diagnoses were obtained in 22 patients (48%). EUSFNA was diagnostic in 40 patients (87%). The diagnostic accuracy of cytology for differentiating between benign and malignant lesions was 82%; diagnostic error occurred in three patients (6%). The cytologic results influenced clinical judgment in 78% cases. The primary reasons for negative or no clinical impact were false-negative results, misdirected patient management, and inconclusive cytology.
Conclusions: EUS-FNA exhibited an 87% diagnostic yield for gastrointestinal intramural lesions; the accuracy of cytology for differentiating malignancy was 82%. The limitations of EUS-FNA were primarily because of nondiagnostic sampling (9%) and probable diagnostic error (6%); these factors may influence the clinical role of EUS-FNA.
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KEYWORD
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Accuracy, Endoscopic ultrasound-guided fine needle aspiration, Extraintestinal mass, Intramural mass, Yield
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