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Gut 1999;44:720-726 doi:10.1136/gut.44.5.720
  • Endoscopy

Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience

  1. D B Williamsa,
  2. A V Sahaia,
  3. L Aabakkena,
  4. I D Penmana,
  5. A van Velsea,
  6. J Webbb,
  7. M Wilsonb,
  8. B J Hoffmana,
  9. R H Hawesa
  1. aDigestive Disease Centre, Medical University of South Carolina, Charleston, South Carolina, USA, bDepartment of Pathology, Medical University of South Carolina, Charleston, South Carolina, USA
  1. Dr D B Williams, Department of Gastroenterology, St Vincent’s Public Hospital, Victoria Street, Darlinghurst NSW 2010, Australia.
  • Accepted 18 November 1998

Abstract

BACKGROUND Endoscopic ultrasound guided fine needle aspiration biopsy (EUS-FNA) is a recent innovation in the evaluation of gastrointestinal and pulmonary malignancies.

AIMS To review the experience with EUS-FNA of a large single centre.

METHODS 333 consecutive patients underwent EUS-FNA. Follow up data were available on 327 lesions in 317 patients, including 160 lymph nodes, 144 pancreatic lesions, 15 extraintestinal masses, and eight intramural tumours.

RESULTS A primary diagnosis of malignancy was obtained by EUS-FNA in 62% of patients with clinically suspicious lesions. The overall accuracy of EUS-FNA for the diagnosis of malignancy was 86%, with sensitivity of 84% and specificity of 96%. With respect to lesion types, the sensitivity, specificity, and accuracy were 85%, 100%, and 89% for lymph nodes; 82%, 100%, and 85% for pancreatic lesions; 88%, 100%, and 90% for perirectal masses; and 50%, 25%, and 38% for intramural lesions, respectively. Compared with size and sonographic criteria, EUS-FNA in the evaluation of lymph nodes provided superior accuracy and specificity, without compromising sensitivity. Inadequate specimens were obtained from only six patients, including 3/5 with stromal tumors. Only one complication occurred.

CONCLUSIONS EUS-FNA is safe and can readily obtain tissue specimens adequate for cytopathological diagnoses. Compared with size and sonographic criteria, it is a superior modality for the detection of nodal metastases. While providing accurate diagnosis of pancreatic and perirectal malignancies, results suggest the technique is less useful for intramural lesions.

Footnotes

  • Abbreviations:
    CT
    computed tomography
    EUS-FNA
    endoscopic ultrasound guided fine needle aspiration biopsy
    NSCLC
    non-small cell lung cancer

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