내시경초음파 유도하 비장 조직 검사의 유용성 및 안전성

Abstract

Background and aims: Percutaneous biopsies are used for the diagnosis of spleen lesions. Much lower adverse event rates for percutaneous splenic biopsies have been demonstrated in recent studies compared with the adverse event rates in previous investigations. However, the risk of serious adverse events is still concerning. Endoscopic ultrasound (EUS)-guided biopsy is also an accepted technique for splenic tissue acquisition. However, the two biopsy methods have not been compared. Thus, we compared the clinical outcomes and adverse events of the two techniques. Methods: This retrospective analysis included 60 patients who underwent EUS-guided or percutaneous spleen biopsies from 2015 to 2021. The clinical outcomes and adverse events were evaluated. Results: Thirty-six biopsies were EUS-guided and 24 were percutaneous. The sensitivity, specificity, and accuracy were 90.0%, 100%, and 96.8% in the EUS group, and 92.3%, 100%, and 95.0% in the percutaneous group, respectively. Twenty-one diagnoses (35%) were malignant, and the most common diagnosis was lymphoma. Major adverse events occurred in two patients in the percutaneous group, and one of the adverse events required transcatheter arterial embolization and splenectomy due to hemorrhage. No major adverse events were observed in the EUS group, and the overall adverse event rate was significantly lower in the EUS group compared with the rate in the percutaneous group (p = 0.023). Conclusions: EUS-guided spleen biopsies are safe and accurate, with high diagnostic accuracy. The risk of adverse events may be lower for EUS-guided biopsies compared with the rate for percutaneous biopsies.