Diagnostic value and influencing factors of endoscopic ultrasound-guided fine needle aspiration for space-occupying lesions of gastrointestinal adjacent tissue

Objective To investigate the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) on malignant lesions in gastrointestinal adjacent tissue, and further to analyze the risk factors influencing positive rate of EUS-FNA. Methods The clinical data of 171 patients undergoing EUS-FNA from January 2009 to May 2016 were collected. The lesion location, size and characteristics, the number of needle passes, puncture suction negative pressure, size of puncture needle, and years of operator experience in EUS were retrospectively analyzed. Results The overall sensitivity, specificity, and accuracy of EUS-FNA in the diagnosis of malignant lesions were 78.3% (83/106), 100.0% (65/65), and 86.5% (148/171), respectively. The univariable logistic regression analysis demonstrated that the risk factors of EUS-FNA were lesion location, lesion characteristics, and lesion size. In multivariate analysis, larger lesion size (OR=1.029, 95%CI: 1.011-1.047, P=0.001) and lesion characteristics of solid (OR=5.098, 95%CI: 1.324-19.633, P=0.018) were independent factors affecting the positive rate of EUS-FNA. Among 171 cases performed by EUS-FNA, the incidence of postoperative complications was 1.75% (3/171) included 2 cases of fever and 1 case of acute pancreatitis, which were improved after conservative treatment. Conclusion EUS-FNA is a safe and effective method of cytological and histological diagnosis with high accuracy and sensitivity, importantly in distinguish malignancy from benign lesion in gastrointestinal adjacent tissue. Positive rate of diagnosis on malignant lesions by EUS-FNA is positively correlated with lesion size, and EUS-FNA positive rate of solid malignant lesions is significantly higher than that of cystic lesions. Key words: Endosonography; Fine-needle aspiration; Diagnosis; Influencing factors; Space-occupying lesions