الفهرس 
Introduction & Aim of the WorkOnly 14 pages are availabe for public view
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Abstract
The rapidly growing incidence of gastrointestinal malignancies, makes early detection of such lesions a mandatory issue. EUS and EUS-FNA are a very sensitive modality in diagnosis of GIT wall lesions
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: This prospective study was conducted from may 2020 to may 2022, that included 245 patients with mean age 46 years. All included patients had suspected GIT lesions based on sonographic, CT or endoscopic findings, with repeated negative endoscopic biopsies for benign or malignant neoplasms . All patients underwent EUS examination and EUS-FNA in the same session. Endosonographic examination was performed by one expert endosonographer in all the patients in endoscopic ultrasound lab - endoscopy unite – kasr alainy university hospital, using a linear Echoendoscope, with 100% technical success. All sonographic features of GI mucosal and submucosal lesion were recorded. Color flow and doppler sonography was performed to exclude intervening vascular structures and to select a vessel-free needle track. All FNA procedures were performed using a 19, and 22-gauge needle. Alcohol (95%)-fixed slides and formaldehyde (Formalin) blocks were prepared immediately. There was no cytopathologist on site during the endosonographic procedure and all samples were processed at the histopathology lab. All patients were kept under observation for 6 hours for the detection of possible procedure-related complications. No procedure-related complications were reported. All study results were statistically analyzed.
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. Anatomical site, layer of origin, texture, 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.