Value Of Endoscopic Ultrasound Guided Fine Needle Aspiration In The Diagnosis Of Intro-abdominal Lymphoma

Background : Intro-abdominal lymphoma can be found in the image checking,but due to the special position,in previous,we can obtain the abdominal lymph nodes and pathological tissue through CT/Endoscopic ultrasound-guided fine needle aspiration、surgical operation.The first mention of two needs a high level of technology and we can’t get the fine needle aspiration specimen from some position.The second mention of two will create a big wound and can not be accepted by patients.So it is very difficult for clinical diagnosis and got a high rate of misdiagnosing in this kind of diseases,and have a strong impact on the formulation of treating method.Endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)is a new technology of endoscope minimally invasive,it is easy,safe and got a small wound,and can get the diagnosis result quickly.This study is aiming at exploring the application value of Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of intro-abdominal lymphoma.Objective : To investigate the application value and security of Endoscopic ultrasound-guided fine needle aspiration in the diagnosis of intro-abdominal lymphomas.Methods:Search database from our hospital for 23 patients who were suspected diagnosed in intro-abdominal lymphoma through B-mode ultrasound and(or)image checking and undertook Endoscopic ultrasound-guided fine needle aspiration after that from January 2011 to December 2017.Have a retrospective clinical analysis to the size of needle aspiration lymph nodes,cytology result and immunohistochemistry result.Treat EUS-FNA,operation and long-time follow-up visit as the final diagnosis.Value the diagnosis value of EUS-FNA to intro-abdominal lymphomas through sensitivity,specificity,missed diagnosis rate and misdiagnosis rate.Do a value to the veracity of prediction with positive predictive value,negative predictive value.Observe and statistic the complication of aspiration operation :infection,blooding and occurrence rate of holing.Result:There were 15 female and 8 male in the 23 patients.The average age was 60 years old(range25-80years),we got the requested specimen 19 pieces(needle aspiration success rate 82.6%),4 patients’(17.39%)specimen are not satisfied,among them,3 specimen are too small and 1 blood clot’s components of organization is not enough.16 patients were finally diagnosed in lymphoma,2 patients neuroendocrine neoplasm,1 patient malignant fibrous histiotoma,and 3 patients benign lesion.14 patients are diagnosed in lymphoma by cytology,the sensitivity of cytology diagnosis is 81.3%,specificity is 57.1%,positive predictive value is 81.2%,negative predictive value is 57.1%,accuracy rate is 73.9%.14 patients are diagnosed in lymphoma by histology,the sensitivity of cytology diagnosis is 93.3%,specificity is 100%,positive predictive value is 100%,negative predictive value is 80%,accuracy rate is 94.7%,missed diagnosis rate is 6.7%,misdiagnosis rate is 0.All the patients did not appear the relative complication.Conclusion: Endoscopic ultrasound-guided fine needle aspiration is an accurate 、safe and functional method to the diagnosis of intro-abdominal lymphomas.And has a high application value in clinical.