超声内镜引导经食管细针穿刺采样肺肿块的诊断性能与安全性

EUS-guided transesophageal fine-needle biopsy sampling of lung masses: diagnostic performance and safety

GASTROINTESTINAL ENDOSCOPY

影响因子:7.5

分区:医学1区 Top / 胃肠肝病学2区

发表日期:2025 Feb

作者: Giacomo Emanuele Maria Rizzo, Mario Traina, Dario Ligresti, Lucio Carrozza, Gabriele Rancatore, Rosa Liotta, Alessandro Bertani, Ilaria Tarantino

DOI: 10.1016/j.gie.2024.09.042

摘要

肺部肿块在超声内镜（EUS）组织采集领域中具有较大的诊断挑战性，尤其是通过经食管EUS引导的细针穿刺活检（EUS-FNB）进行采样。本研究评估了肺部病变的EUS-FNB的可行性、诊断性能和安全性。共有53名患者被纳入前瞻性登记研究。所有EUS操作由经验丰富的内镜超声医师执行。主要观察指标包括标本充分性、诊断准确性、诊断敏感性、诊断特异性及安全性。患者平均年龄为70 ± 10.4岁，男性占71.7%。肿块平均大小为52.4 ± 23.3毫米，大多数患者为单一病灶（86.8%）。大部分患者在诊断时处于晚期（IV期，41.82%），最常见的肺癌为非小细胞肺癌（69.4%）。诊断充分率为92.86%，诊断准确率为87.5%。在三例操作中报告发生不良事件。经食管EUS-FNB是一种可行且安全的肺肿块组织取样诊断方法，尤其适用于通过EUS可达的肺部病变。

Abstract

Pulmonary masses are a diagnostic challenge in the field of EUS tissue acquisition, especially through transesophageal EUS-guided fine-needle biopsy sampling (EUS-FNB). Our study evaluated the feasibility, diagnostic performance, and safety of EUS-FNB of pulmonary lesions.Fifty-three patients were enrolled in a prospective registry. All EUS procedures were performed by experienced endosonographers. Outcomes were specimen adequacy, diagnostic accuracy, diagnostic sensibility, diagnostic specificity, and safety.The mean patient age was 70 ± 10.4 years, and 71.7% were men. The mean lesion size was 52.4 ± 23.3 mm, and patients mostly had a single lesion (86.8%). Most patients had an advanced stage at diagnosis (stage IV, 41.82%), and the most common lung cancer was non-small cell lung carcinoma (69.4%). The diagnostic adequacy rate was 92.86%, and diagnostic accuracy was 87.5%. Adverse events were reported in 3 procedures.Transesophageal EUS-FNB is a feasible and safe diagnostic method of tissue sampling for lung masses reachable by EUS.