Diagnostic Efficacy Of Different Pathological Methods Of Tissue Samples Obtained By EUS-FNA: A Prospective Study

Objective: To investigate the diagnostic value of different pathological methods of tissue samples obtained by ultrasound-guided fine needle aspiration(EUS-FNA)for the solid lesions around the digestive tract.Methods: 52 patients(a total of 65 cases)with solid lesions around the digestive tract.were recruited in this study,who underwent EUS-FNA by the same endoscopic physician in the Second Affiliated Hospital Of Soochow University from December 2016 to January 2018.The EUS-FNA samples of all patients were processed by conventional smear cytology,liquid-based cytology,cell block and histopathology.All the pathologic results were tracked after EUS-FNA to investigate the diagnostic value of different pathological methods.Results: This study included 52 patients(a total of 65 cases)with solid lesions around the digestive tract.Among them,53 cases were malignant lesions,and 12 cases were benign lesions.The diagnostic accuracy of conventional smear cytology,liquid-based cytology,cell block and histopathology method were 96.9%(63/65)?89.2%(58/65)?91.9%(57/62)?48.1%(25/52),respectively.The combined diagnostic accuracy of the four methods is 100%(65/65).The diagnostic accuracy rate of the smear cytology was higher than the cell block(p <0.05)and the liquid-based cytology(p <0.05).And the diagnostic accuracy rate of cytology methods was significantly higher than histopathology method(p <0.05).The diagnostic sensitivity of smear cytology,liquid-based cytology,cell block and histopathology method 96.2%(51/53)?86.8%(46/53)?90.4%(47/52)?37.2%(16/43),The diagnostic specificity of four methods were all 100%..Conclusion: Endoscopic ultrasound-guided fine-needle aspiration was a safe and effective method with high sensitivity and specificity in the diagnosis of solid lesions around the digestive tract.The diagnostic accuracy rate of cytology methods was obviously higher than histopathology method.Cell block method combining immunohistochemistry might help to increase the diagnosis and histological diagnosis of lesions.The combination of multiple pathological methods in EUS-FNA can increase the final diagnostic efficiency.