Role of Endoscopic Ultrasound and Endoscopic Ultrasound Guided Fine Needle Aspiration in Endoscopic Biopsy Negative Gastrointestinal Lesion

Abstract

Abstract Introduction The rapidly growing incidence of gastrointestinal malignancies, makes early detection of such lesions a mandatory issue. EUS is a very sensitive modality in diagnosis of GIT wall lesions with superiority in diagnostic yield over conventional endoscopy, and non- invasive diagnostic modalities as CT and MRI. Aim To assess the feasibility, safety and accuracy of endoscopic ultrasound and endoscopic ultrasound guided fine needle aspiration in diagnosis of endoscopic biopsy negative gastrointestinal lesions. Material and Methods We conducted this prospective study over the period of 2 years that included 245 patients with mean age 46 years. All included patients had suspected GIT lesions with repeated negative endoscopic biopsies. All patients underwent EUS examination and EUS- FNA in the same session. Results EUS diagnosis SE, SP, PVP, PVN, LR+, LR-, and, DiAc were 0.94, 0.90, 0.93, 0.91, 9.11, 14.7, and 0.92 respectively, while EUS-FNA SE, SP, PVP, PVN, LR+, LR-, and DiAc were 0.86, 0.99, 0.99, 0.83, 83.89, 7.32, and 0.91respectively, with 100% technical success. Size of the lesion, size of the needle, and number of needle passes had no impact on diagnostic yield of EUS-FNA. No procedure related complications were reported. Conclusions EUS with EUS-FNA is a safe, feasible modality with high diagnostic accuracy in diagnosis of endoscopic biopsy negative gastrointestinal lesions irrespective to anatomical location of the lesion, layer of origin, lesion size, lesion echotecture, and no impact of needle size and number of needle passes on the diagnostic yield of EUS and EUS-FNA.