超声内镜引导细针穿刺抽吸术对内镜普通活检无法诊断的食管狭窄性病变的应用价值

Clinical value of endoscopic ultrasound-guided fine needle aspiration for esophageal stricture lesions that cannot be diagnosed by endoscopic general biopsy

摘要:

目的 探讨超声内镜引导细针穿刺抽吸术（EUS-FNA）对内镜普通活检无法诊断的食管狭窄性病变的临床应用价值。方法 回顾性分析2021年1月－2023年6月该院因内镜普通活检无法明确诊断而行EUS-FNA的6例食管狭窄性病变患者的临床资料，以最终手术病理或随访结果为诊断标准，分析EUS-FNA对内镜普通活检无法诊断的食管狭窄性病变的诊断准确性。结果 所有患者均接受EUS-FNA，穿刺病理明确诊断为恶性肿瘤5例，慢性炎症1例。其中，5例患者接受外科手术，术后病理与穿刺病理相符，1例患者长期随访并复查胃镜，临床表现和普通胃镜结果均无恶性肿瘤证据，考虑仍为炎性改变，与穿刺病理结果一致。所有患者未发生腹痛、出血、穿孔和感染等并发症。结论 EUS-FNA用于诊断普通内镜活检无法诊断的食管狭窄性病变，是一种安全有效的方法，有较高的临床应用价值。

Abstract:

Objective To investigate the clinical value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) for esophageal stricture lesions that cannot be diagnosed by endoscopic general biopsy.Methods The clinical data of 6 patients with esophageal stricture lesions with EUS-FNA that cannot be clearly diagnosed by endoscopic general biopsy from January 2021 to Jun 2023 were retrospectively analyzed, and the accuracy of EUS-FNA was analyzed for esophageal stricture lesions that cannot be diagnosed by endoscopic general biopsy, while the results of surgery pathology or final follow-up results was taken as the diagnostic criteria.Results All the patients underwent EUS-FNA. The puncture clearly diagnosed 5 cases of malignancy and 1 case of chronic inflammation. Among them, 5 patients underwent surgical operations, and the postoperative pathological findings were consistent with the puncture pathology. One patient was followed up for a long time and had repeated gastroscopy. There was no evidence of malignant tumor in the clinical manifestations and routine gastroscopic findings, so it was still considered to be an inflammatory change, which was consistent with the puncture pathological result. All patients had no complications, including abdominal pain, bleeding, perforation, and infection.Conclusion EUS-FNA is an effective and safe method for esophageal stricture lesions that cannot be diagnosed by endoscopic general biopsy and has high clinical application value.