Clinical Efficacy of Endoscopic Ultrasound-guided Fine Needle Aspiration (EUS-FNA) Performing in Upper Abdomen: A Single Center Experience
Keywords:
Endoscopic ultrasound, fine needle aspiration, efficacy, EUS-FNAAbstract
Background: Endoscopic ultrasound with fine needle aspiration (EUS-FNA) is a useful procedure for the evaluation and tissue acquisition of lesions located in organs close to the upper gastrointestinal tract, such as the pancreas, periceliac lymph nodes, aortocaval lymph nodes, left lobe of liver, bile duct, retroperitoneal masses or lesions located in the wall of upper gastrointestinal tract itself, and also masses located in mediastinum. EUS-FNA can provide tissue samples for cytological or pathological analysis that is helpful for the diagnosis, tumor staging, and management of many surgical conditions. The authors conducted the present study to evaluate the accuracy of EUS-FNA performed at Rajavithi Hospital.
Objective: To evaluate the results of diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of EUS-FNA performed at a tertiary gastrointestinal endoscopic center of the Department of Surgery, Rajavithi Hospital.
Material and method: The authors retrospectively reviewed the EUS-FNA database obtained between October 2014 and September 2016. Data obtained, including demographics, organ of examination, results of cytological and/or pathological reports, size of the needles and follow-up data, were analyzed and reported.
Results: EUS-FNA was performed in 172 patients (90 males, 82 females), with a mean age of 54.8 years (range 17-89 years). The overall diagnostic accuracy was 91.9%, with a sensitivity of 88.1%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 81.8%. Patients were divided into four groups according to anatomical location, i.e., pancreas, stomach, lymph nodes and other locations. The majority of the EUS-FNA was performed on the pancreas, which included 124 patients. There were 15 patients with stomach lesions, 19 with lymphadenopathy and 14 with other lesions. The sensitivity of EUS-FNA for each group varied from 84.6% to 93.7%. The specificity was 100% for every group due to no false positive result, and the accuracy ranged from 86.7 to 94.7%. No serious complications occurred in all patients.
Conclusion: EUS-FNA performed at the Gastrointestinal Endoscopic Center, Department of Surgery, Rajavithi Hospital, is a safe and accurate diagnostic procedure which is very useful for management planning.
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