Differences In Diagnostic Efficacy Of Different Treatment Methods For EUS-FNA Specimens

Objective :To compare and analyze the diagnostic efficiency of specimens obtained by EUS-FNA in different methods.Methods : Clinical data of 96 cases of fine-needle aspiration(EUS-FNA)biopsy performed by the same experienced endoscopist in the First Affiliated Hospital of Guangxi Medical University from April 2012 to June 2019 were collected.EUS-FNA postoperative specimens are sent for cytology + histology examination.Among them,cytology methods include traditional cell smears,liquid-based cytology and rapid on-site cytology evaluation(c-rose),and histology includes tissue strips and cell masses.Comparing the final diagnosis of patients,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of various specimen processing methods were calculated.Finally,the sensitivity and accuracy of different specimen processing methods were compared and analyzed.Results: Among the 96 cases included,there were 62 males and 34 females with a male to female ratio of 2: 1;the average age was 52.81 ± 14.22 y,the lesion size was 33.93 ± 18.23 mm in diameter,and the number of FNA punctures was3.82 ± 3.47.66 cases of malignant tumors and 30 cases of benign lesions were finally diagnosed.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of simple traditional cell smear diagnosis after EUSFNA puncture were 78.4%,90%,82.2%,95.2% and 66.7%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of liquid-based cytology were 87.5%,90.9%,88.9%,93.3%,and83.3%,respectively.The rapid on-site cytological evaluation of sensitivity,specificity,accuracy,positive predictive value,and negative predictive value were 87.5%,88.9%,88.0%,93.3%,and 80.0%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of the cell block method were 86.5%,100%,90.7%,100%,and 77.3%,respectively.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of tissue strips were 69.0%,100%,78.6%,100%,and 65.0%,respectively.Under the same conditions,the sensitivity and accuracy of liquidbased cytology and cell masses are higher than that of traditional cell smears,and the sensitivity and accuracy of traditional cell smears are higher than those of tissue strips.There is no significant difference.In the cytology test,there were 2false positives in traditional cell smears,and 1 false positive in liquid-based cytology and rapid cytology.The satisfaction of cell block specimens was 98.1%,and the satisfaction of tissue strip specimens was 90.5%.All patients had no serious complications.Conclusion: EUS-FNA has a high diagnostic efficiency for space-occupying lesions outside the digestive tract.Among them,the detection rate of cytology specimens detected by liquid-based cytology after EUS-FNA was significantly higher than that of traditional cell smears.The diagnostic efficiency of the cell mass is higher than the traditional cell smear method,and the diagnostic efficiency of the simple tissue strip method may be the lowest.Cytological tests may be more prone to misdiagnosis,while histological tests require higher specimens...