化学・放射線療法後のリンパ節に対するEUS-FNAによる効果判定

Reevaluation of Malignant Lymphadenopathy after Chemo/Radiation Therapy Using EUS-FNA

要旨　化学・放射線療法後のリンパ節病変に対するEUS-FNAの診断能について検討した．対象症例は16例，内訳はリンパ腫3例，転移性リンパ節13例（肺癌10例，胃癌2例，大腸癌1例）で，リンパ節の存在部位は，縦隔13例，腹腔内3例であった．EUS-FNAによる病理検体採取は全例に可能であり，その診断能は，正診率88％，感度82％，NPV71％であった．EUS-FNAの診断能は高く，化学・放射線療法後の治療方針を決定するうえで有用な検査手技と考えられる．

　We examined the yields of EUS-FNA for reevaluation of malignant lymphadenopathy after chemo/radiation therapy. A total of 16 patients were enrolled to this retrospective study. They included 3 lymphomas and 13 metastatic lymphadenopathies the original malignancy was lung cancer in 10 cases, gastric cancer in 2, and colonic cancer in 1. The lymph nodes were located in the mediastinum in 13 cases and were intraabdominal in 3 cases. Pathological material was successfully obtained by EUS-FNA in all cases. The accuracy, sensitivity, and negative predictive value of EUS-FNA was 88％, 82％, 71％, respectively. EUS-FNA is useful for determining the treatment strategy after chemo/radiation therapy.