下载掌阅APP，畅读海量书库
立即打开
和间叶性肿瘤等。细针穿刺的诊断作用很小。个别情况下，肠道黏膜下的包块病变，如GIST（图3-23）、平滑肌瘤（图3-24）、脂肪瘤等可以利用EUS-FNA取得足够的样本进行诊断。其细胞学特征见第三节。
图3-23 结肠黏膜下GIST，内镜指导下的FNA穿刺样本
A. 松散的梭形细胞团，异型性不明显（200×，巴氏染色）
B. 梭形细胞团，细胞排列紧密（400×，Diff-Quik染色）
C. FNA样本制成的细胞块（100×，HE染色）
D. DOG1染色强阳性（200×）
E. c-kit染色强阳性（200×）
（Dr. Zhongren Zhou，Rochester Medical Center，NY惠赠）
图3-24 结肠黏膜下平滑肌瘤FNA穿刺样本
A. 间质成分及少许梭形细胞（200×，Diff-Quik染色）
B. 梭形细胞团，细胞核细长，无细胞异型性（400×，巴氏染色）
C. FNA标本制成的细胞块组织切片（200×，HE染色）
D. 平滑肌标记物SMA染色阳性（200×）
E. CD117/c-kit染色阴性（200×）
F. DOG1染色阴性（200×）
（Dr. Zhongren Zhou，Rochester Medical Center，NY惠赠）
1. Pan QJ, Roth MJ, Guo HQ, et al. Cytologic detection of esophageal squamous cell carcinoma and its prescursor lesions using balloon samplers and liquid-based cytology in asymptomatic adults in Linxian, China. Acta Cytologica, 2008, 52（1）: 14-23.
2. Vazquez-Sequeiros E, Norton ID, Clain JE, et al. Impact of EUS-guided fine needle aspiration on lymph node staging in patients with esophageal carcinoma. Gastrointest Endosc, 2001, 53（7）: 751-757
3. Peng HQ, Greenwald BD, Tavora FR, et al. Evaluation of performance of EUS-FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreas. Diagn Cytopathol, 2008, 36: 290-296
4. Giovannini M, Monges G, Seitz JF, et al. Distant lymph node metastases in esophageal cancer: Impact of endoscopic ultrasound-guided biopsy. Endoscopy, 1999, 31（7）: 536-540.
5. Gutmann EJ, Suriawinata A, Gordon S. Barrett's esophagus with high grade dysplasia simulating metastatic adenocarcinoma in a fine needle biopsy. Diagn Cytopathol, 2006, 34: 507-510.
6. O'Toole D, Palazzo L, Arotacarena R, et al. Assessment of complications of EUS-guided fine needle aspiration. Gastrointestinal Endoscopy, 2001, 53（4）: 470-474.
7. Gleeson FC, Kipp BR, Caudill JL, et al. False positive endoscopic ultrasound fine needle aspiration cytology: incidence and risk factors. Gut, 2010, 59: 586-594.
8. Hoover L, Berman JJ. Epithelial repair versus carcinoma in esophageal brush cytology. Diagn Cytopathol, 1988, 4: 217-223.
9. Lin J, Zeng R, Cao W, et al. Hot beverage and food intake and esophageal cancer in Southern China. Asian Pac J Cancer Prev, 2011, 12: 2189-2192.
10. Mao WM, Zheng WH, Ling ZQ. Epidemiologic risk factors for esophageal cancer development. Asian Pac J Cancer Prev, 2011, 12（10）: 2461-2466.
11. Falk GW. Risk factors for esophageal cancer development. Surg Oncol Clin N Am, 2009, 18（3）: 469-485.
12. Wang JB, Fan JH, Liang H, et al. Attributable causes of esophageal cancer incidence and mortality in China. PLoS One, 2012, 7（8）: e42281.
13. Wang LD, Yang HH, Fan ZM, et al. Cytological screening and 15 years follow up（1986-2001）for early esophageal squamous cell carcinoma and precancerous lesions in a high risk population in Anyang County, Henan Province, Northern China. Cancer Detect Prev, 2005, 29（4）: 317-322.
14. Hongo M, Nagasaki Y, Shoji T. Epidemiology of esophageal cancer: Orient to occident. Effects of chronology, geography and ethnicity. J Gastroenterol Hepatol, 2009, 24（5）: 729-735.
15. Qi YJ, Chao WX, Chiu JF. An overview of esophageal squamous cell carcinoma proteomics”. J Proteomics, 2012, 75（11）: 3129-3137.
16. Ashktorab H, Nouri Z, Nouraie M, et al. Esophageal carcinoma in African-Americans: A five-decade experience. Dig Dis Sci, 2011, 56（12）: 3577-3582.
17. Brown LM, Devesa SS, Chow WH. Incidence of adenocarcinoma of the esophagus among white Americans by sex, stage, and age. J Natl Cancer Inst, 2008, 100（16）: 1184-1187.
18. Ho KY. From GERD to Barrett's esophagus: Is the pattern in Asia mirroring that in the West?. J Gastroenterol Hepatol, 2011, 26（5）: 816-824.
19. Chan AO, Wong BC, Lam SK. Gastric cancer: Past, present and future. Can J Gastroenterol, 2001, 15: 469-474.
20. Ando N, Goto H, Niwa Y, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc, 2002, 55（1）: 37-43.
21. Gu M, Ghafari S, Nguyen PT, et al. Cytologic diagnosis of gastrointestinal stromal tumors of stomach by endoscopic ultrasound-guided fine needle aspiration biopsy: Cytomorphologic and immunohistochemical study of 12 cases. Diagn Cytopathol, 2001, 25: 343-350.
22. Bardales RH, Stelow EB, Mallery S, et al. Review of endoscopic ultrasound guided fine needle aspiration cytology. Diagn Cytopathol, 2006, 34（2）: 140-175.
23. Fu K, Eloubeidi MA, Jhala NC, et al. Diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration biopsy: A potential pitfall. Ann Diagn Pathol, 2002, 6: 294-301.
24. Grover S, Ashley SW, Raut CP. Small intestine gastrointestinal stromal tumors. Current Opinion Gastroenterol, 2012, 28: 113-123.
25. Klapman JB, Logrono R, Dye CE, et al. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound guided fine needle aspiration. Am J Gastroenterol, 2003, 98: 1289-1294.