Abstract:
PURPOSE: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is used for about 30 years in the upper gastrointestinal tract (GI), the surrounding organs, and altered structures. Purpose of this study was to investigate the value of EUS-FNA on not-optimized clinical daily routine conditions.
MATERIALS & METHODS: We retrospectively analysed the data of all patients with an EUS-FNA in the upper GI-tract between January 2002 and April 2010 in Katharinenhospital, Stuttgart. Cytological and histological results, like other laboratory-confirmed issues, which were determined by EUS-FNA, were compared with the final diagnosis.
RESULTS: We performed 236 EUS-FNA on 193 patients (average age 62,6 years, 68 women, 125 men). 201 samples were adequate (85,2%). The overall sensitivity, specificity and accuracy averaged 66,7%, 99,1% and 84,8%. The results of lymph node EUS-FNAs were better (77,3%, 100%, 92,1%) than the EUS-FNAs of solid pancreatic tumours (36%, 83,3%, 45%). The complication rate was 3%. For lymph node FNA, a positive learning curve within the study period could be observed.
CONCLUSION: On clinical daily routine EUS-FNA performs slightly inferior than under study conditions. However, it is a fundamental part of gastrointestinal survey and a valuable device to adjust differential diagnoses. EUS-FNA shows a minimal invasive technique and an important, radiation-free and low-risk complement to conventional examination methods (CT, MRT, US), with very high specificity.