Experience of endoscopic ultrasound-guided fine needle aspiration in a regional teaching hospital.
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was first reported in 1991 and 1992 for gastric submucosal tumor and pancreas cancer. Subsequently, the indications have expanded to mediastinal lesions, liver, spleen, adrenal gland, ascites, pleural effusion, intra-abdominal lymph nodes. We report our experience of EUS-FNA and the number of cases required during the learning curve. From May 2005 to December 2007, we did a retrospective analysis of 45 cases (median age: 68 [range] [37-87] years; 34 men and 11 women) of EUS-FNA punctures on solid masses. EUS-FNA was performed with linear echoendoscope (Olympus GF-UCT2000, EUC2000 unit) using 22 gauge needles (Olympus power-shot needle and Wilson Cook echo-tip needle). The procedure was done by a single endoscopist. Patients were divided into 2 groups, the first 30 patients (group A) and the last 15 patients (group B). The median size of tumor was 2.6 cm (range: 1-14 cm) in group A and 2 cm (range: 0.7-3.5 cm) in group B (p=0.023). The median number of punctures was the same in both groups, i.e. 2 (range: 1-4). The sensitivity, specificity, positive predictive value, negative predictive value, accuracy in groups A and B were 55.1% vs. 85.7%, 100% vs. 100% 100% vs. 100%, 7.1% vs. 33.3%, 56.6% vs. 86.6% respectively. Group B patients had smaller tumor size, but with higher sensitivity and accuracy rates. Only one patient in group A needed 4 units of blood transfusion. EUS-FNA is a safe intervention; the sensitivity and accuracy rate can be improved after a learning curve of 30 cases.
Lin
Lien-Fu
LF
Division of Gastroenterology, Department of Internal Medicine, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, ROC. aucardla@yahoo.com.tw
Tung
Jai-Nien
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods*; D019160:Endosonography / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006784:Hospitals, Teaching; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D018084:Ultrasonography, Interventional