Ardengh José Celso, Paulo Gustavo Andrade de, Nakao Frank Shigueo, Venco Filadélfio, Santo Giulio Cesare, Geocze Stephan
Endoscopy Unit, Division of Gastroenterology, Universidade Federal de São Paulo, Brazil.
Acta Gastroenterol Latinoam. 2008 Jun;38(2):105-15.
endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) allows cytologic and/or histologic diagnosis of lesions within or adjacent to the gastrointestinal tract. However, the amount of tissue obtained with a regular 22 gauge needle is not always satisfactory. With the development of a needle XNA-10J-KB (Shot-Gun) that resembles the automatic liver biopsy needle, it is expected that significant samples be obtained more frequently (core biopsy), optimizing histological analysis.
to compare samples obtained with EUS-FNA using 3 different needle systems: GIP, NA-10J-1 and Shot-Gun.
19 patients underwent EUS-FNA for diagnosis (5) or tumor staging (14). Mean age was 58.9 years (range 27-82), being 50% men. All patients were submitted to EUS-FNA with the 3 needle models. The Shot-Gun model was "shot" when its tip was near the target inside the lesion, followed by aspiration. Samples were submitted for cytologic and histologic examination.
mean lesion size was 3.0 cm (range 0.8-5.5 cm). Final diagnoses were made after surgery or intra-operative biopsy: 13 pancreatic tumors (12 adenocarcinomas and 1 neuroendocrine tumor), 4 chronic pancreatitis, 1 acute pancreatitis, and 1 cholangiocarcinoma. Specimens adequate for cytologic diagnosis were obtained in 13/19 (68. 4%) patients using GIP model, in 14/19 (73.7%) with NA10J-1 model, and in 17/19 (89.5%) with ShotGun, model (p=0.039). Histologic analysis was possible in 10/19 (52.6%) patients using the GIP model, in 14/19 (73.7%) with NA10J-1, and in 17/19 (89.5%) with Shot-Gun, model (p=0.005). Adequate samples for cytologic or histologic assessment in 16/19 (84.2%) patients using the GIP model, in 17/19 (89.5%) with NA10J-1, and in 18/19 (94.7%) with Shot-Gun, model (p=0.223). In two cases biopsies were negative due to very hard tumors.
the Shot-Gun needle obtained better samples for histological diagnosis than NA10J-1 needle and GIP.
内镜超声引导下细针穿刺抽吸术（EUS-FNA）可对胃肠道内或其附近的病变进行细胞学和/或组织学诊断。然而，使用常规22号针获取的组织量并不总是令人满意。随着一种类似于自动肝活检针的XNA-10J-KB针（霰弹枪针）的开发，预计能更频繁地获取大量样本（核心活检），从而优化组织学分析。
比较使用3种不同针系统（GIP、NA-10J-1和霰弹枪针）进行EUS-FNA所获得的样本。
19例患者接受EUS-FNA用于诊断（5例）或肿瘤分期（14例）。平均年龄为58.9岁（范围27 - 82岁），男性占50%。所有患者均使用这3种针型号进行EUS-FNA。当霰弹枪针的针尖靠近病变内的目标时进行“射击”，然后抽吸。样本进行细胞学和组织学检查。
病变平均大小为3.0厘米（范围0.8 - 5.5厘米）。最终诊断在手术后或术中活检后做出：13例胰腺肿瘤（12例腺癌和1例神经内分泌肿瘤），4例慢性胰腺炎，1例急性胰腺炎，1例胆管癌。使用GIP型号在13/19（68.4%）的患者中获得了足以进行细胞学诊断的标本，使用NA10J-1型号在14/19（7
