Clinical Application Value Of Percutaneous Biopsy Of Gastrointestinal Masses Guided By Abdominal-Ultrasound

Objective:To explore the clinical application value of percutaneous biopsy of gastrointestinal tumors guided by abdominal-ultrasound.Methods:The study retrospectively analyzed 50 patients who underwent ultrasound-guided biopsy and diagnosis were confirmed as gastrointestinal tumors either by surgery resections or by biopsies in the Department of Medical Ultrasonic of the first affiliated hospital of Sun Yat-sen University from January 2010 to October 2019.It was divided into abdominal ultrasound biopsy group(including conventional ultrasound and contrast-enhanced ultrasonography)and endoscopic biopsy group,conventional ultrasound biopsy group and contrast-enhanced ultrasound(CEUS)biopsy group,lesions maximum diameter <5cm group and ≥5cm group,different growth types of gastrointestinal masses group.To analyze the satisfaction rate and the success rate of puncture diagnosis,the number of puncture needles and the overall incidence of related complications of diagnosis the gastrointestinal tumors by different groups to explore the efficacy and safety.Results:1.Of the 50 cases underwent ultrasound-guided biopsy,the final clinical diagnosis showed42 cases of malignant lesions and 8 cases of benign lesions.The abdominal ultrasound-guided puncture biopsy had a high puncture specimen satisfaction rate of94.0%(47/50)and a puncture diagnosis success rate of 90.0%(45/50).2.There were 12 cases of swellings puncture biopsy under abdominal ultrasound and endoscopic,8 exogenous cases,2 in-wall cases,2 endogenous cases,the specimen satisfaction rate of abdominal ultrasound-guided puncture biopsy and endoscopic biopsy for endogenous masses for exogenous swelling were 100%.The puncture diagnosis success rate of abdominal ultrasound-guided puncture diagnosis of exogenous swelling biopsy was 100%,which was similar to that of the endogenous masses by endoscopic biopsy.3.Of the 50 cases in the group,there were 37 exogenous cases,9 in-wall cases,4endogenous cases.the difference in these three types of puncture specimen satisfaction rate and puncture diagnosis success rate,was not statistically significant(P=0.158,P=0.560,P>0.05).The specimen satisfaction rate and puncture diagnosis success rate of exogenous cases and in-wall cases was higher in abdominal ultrasound-guided puncture biopsy,but no statistical difference.4.Of the 50 cases in the group,8 case were confirmed by CEUS-guided puncture biopsy,the satisfaction rate(95.2%)and the diagnostic success rate(90.5%)of ultrasound-guide were higher than that in CEUS-guided biopsy(87.5%,87.5%),but the sample size was small.5.The puncture specimen satisfaction rate of lesions maximum diameter <5cm group was94.1%(16/17),its puncture diagnosis success rate was 88.2%(15/17).Puncture specimen satisfaction rate of lesions maximum diameter ≥5 cm group was 93.9%(31/33),puncture diagnosis success rate was 90.9%(30/33).No significant difference between the two modalities(P=1.000,P>0.05).The maximum ≥5cm group had more cases,there were no statistical differences between the size of lesions groups,and the satisfaction rate of puncture specimens and the success rate of puncture diagnosis of them were similar.6.Of the 50 cases in the group,in one operation,36 were punctured with 2 needles,8were sampled with 3 needles.The puncture specimen satisfaction rate and specimen satisfaction rate of puncturing with 2 needles were 92.3%(36/39)and 89.7%(35/39).The puncture specimen satisfaction rate and specimen satisfaction rate of puncturing with 3 needles were 100%(8/8)and 87.5%(7/8).The difference between the satisfaction rate of puncture specimens and the success rate of puncture diagnosis were not statistically significant when they were sampled with 2 and 3 needles(P=1.000,P=1.000,P>0.05).7.In this study,2 cases of mild abdominal pain were reported after surgery,3 cases of small liquid dark areas around the swelling,the incidence of mild complications was10%(5/50),and no progress was made after treatment of the disease.Conclusions:By abdominal ultrasound-guided puncture biopsy,it can evaluate the puncture path,mainly be applicable to exogenous masses,part of in-wall masses,and larger endogenous masses.And it has the advantages of minimally investing,can real-time dynamic,safe and simple,and with high success rate.When the endoscope cannot be taken or is insufficient,or when the endoscopic biopsy is limited,the abdominal ultrasound-guided puncture biopsy may have advantages and it can become one of the important supplementary means of digestive endoscopy.The abdominal ultrasound-guided puncture biopsy has high clinical application value and deserves to be promoted in clinical application.