Objective To assess the role of endoscopic ultrasound guided fine needle aspiration (EUS-FNA)for diagnosis of gastrointestinal tract lesions.Methods Sixty-eight patients underwent endoscopic uhrasonagraphy and EUS-FNA between May 2007 and Dec.2008.The result of cytology and/or pathology was compared with that of surgical finding and follow-up study.Results EUS-FNA was successfully performed on 62 patients with lesiorm in oesophagus(4 eases),stomach(19 case),rectum(19 cases),liver(3 case),mediastinum(4 cases)and lymph node(13 cases),and had a successful rate of 91.18%(62/68).Among them,the lesions in 40 patients(64.52%)were cytologically confirmed.The lesions in 10 out of 22 patients(35.48%)were pathologically confirmed.Compared with the results of pathology and long-term followe-up study,the sensitivity,specificity and positive predictive value of EUSFNA in diagnosis of lesions in gastrointestinal tract was 85.48%,100.00%and 90.91%,respectively,The positive predictive value and negative predictive value was100.00%and 57.14%,respectively.Conclusion EUS-FNA is a safe,effective and accurate method for diagnosis of lesions in gastrointestinal tract,and has an important role in cytological diagnosis.

Objective To evaluate the significance of immunocytochemistry markers of reactive methothelium(RM),adenocarcioma(AC) and malignant mesothelioma(MM) in cytological differential diagnosis of effusion smear. Methods A total of 170 specimens of effusion were first evaluated by the traditional microscopy with hematoxylin-eosin,and then stained by a panel of immunocytochemistry markers including carcinoembryonic antigen(CEA),epithelial membrane antigen(EMA),epithelial-related antigen(MOC-31),E-cadherin,cytokeratin(CK),vimentin(VIM) and desmin.The immunoreaction results were evaluated independently by two senior cytopathologists and were analysed by double-blind method. Results Statistical significance was found in the expression differentiation among the three groups mentioned above,comparing the groups of RM,AC and MM(P<0.01).CEA,EMA,MOC-31,E-cadherin and CK in the AC group showed high positive rates(88%,97%,89%,92% and 94% respectively),whereas the positive rates of VIM and desmin were low(6% and 11% respectively);The results of VIM and desmin,in group showed high positivity with 84% and 91%,respectively,whereas the results of CEA,EMA,MOC-31 and E-cadherin showed low positivity with 13%,16%,9% and 6%,respectively.The VIM,desmin and CK in the MM group showed high positivity all were 100%. Conclusions Immunocytochemistry study using a panel of monoclonal antibodies is helpful in differential diagnosis between malignant and benign lesions in effusion smears.

Objectives To set up a tele1,cytology network in China and evaluate the diagnostic accuracy of the tele1,cytology. Methods A tele1,cytology project was initiated among 13 hospitals in 8 cities of China. The digital images of 60 cytology samples along with the case information were displayed on web page or transmitted as E1,mail attachment. Participants viewed the representative microscopic images and rendered a tele1,diagnosis. Results A total of 456 responses were obtained. When the tele1,diagnosis was compared to the traditional light microscopic diagnosis, the diagnostic agreement ranged from 86% to 97% with the average value of 94%. The diagnostic certainty was 96% and the acceptability of the image quality reached 98%. Conclusions The accuracy of diagnosis by tele1,cytology is similar to that by conventional light microscopy. The transmission of the cytology digital images via the Internet is the first step in establishing a tele1,cytology system, which may be expanded into the web1,based education program and may act as a professional quality assurance in China as well.