Kida Mitsuhiro, Araki Masao, Miyazawa Shiro, Ikeda Hiroko, Takezawa Miyoko, Kikuchi Hidehiko, Watanabe Maya, Imaizumi Hiroshi, Koizumi Wasaburo
Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan.
J Interv Gastroenterol. 2011 Jul;1(3):102-107. doi: 10.4161/jig.1.3.18508. Epub 2011 Jul 1.
Various factors, such as the optimal number of passes, aspiration pressure, and the use of 19-gauge and Trucut biopsy needles, have been studied to improve the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). We retrospectively compared the diagnostic accuracy of EUS-FNA between 25- and 22-gauge needles, which have been widely used recently. SUBJECTS AND METHODS: The study group comprised 47 consecutive patients who underwent EUS-FNA with both 22- and 25-gauge needles from October 2007 through March 2010. Their underlying diseases were pancreatic cancer in 24 patients, submucosal tumors in 11, other pancreatic tumors in 4, chronic pancreatitis in 4, enlarged lymph nodes in 3, and gall bladder cancer in 1. Tissue specimens, which were pushed out of the puncture needle, were placed into physiological saline solution. Gray-whitish, worm-like specimens were used for histologic diagnosis. The remaining specimen was centrifuged, and the sediment was plated on slides and examined by a cytopathologist to obtain the cytologic diagnosis. RESULTS: A total of 75 punctures (mean, 1.6) were performed with 25-gauge needles, and 69 punctures (mean, 1.4) were performed with 22-gauge needles. The overall tissue-sampling rate for cytology was 100% (47/47), which was significantly (p=0.01) superior to 83% (39/47) for histology. The overall diagnostic accuracy on the cytologic and histologic examinations was 79% (37/47) and 85% (33/39) (p=0.48). According to needle type, the tissue-sampling rate for cytology and histology on each puncture was 97% (73/75) and 56% (42/75) with 25-guage needles, and was 97% (67/69) and 58% (40/69) with 22-guage needles, the accuracy of cytologic diagnosis on each puncture was 73% (53/73) with 25-gauge needles and 66% (44/67) with 22-gauge needles (p=0.37); the accuracy of histologic diagnosis on each puncture was 60% (25/42) and 75% (30/40) (p=0.14), respectively. No patient had complications. CONCLUSIONS: The tissue-sampling rate and diagnostic accuracy did not differ significantly between 22- and 25-gauge needles in patients with pancreatic or gastrointestinal diseases who underwent EUS-FNA.
为提高内镜超声引导下细针穿刺抽吸术（EUS-FNA）的诊断准确性，人们对多种因素进行了研究，如最佳穿刺次数、抽吸压力以及19号和Trucut活检针的使用等。我们回顾性比较了最近广泛使用的25号和22号针在EUS-FNA中的诊断准确性。
研究组包括2007年10月至2010年3月期间连续接受22号和25号针EUS-FNA的47例患者。他们的基础疾病包括24例胰腺癌、11例黏膜下肿瘤、4例其他胰腺肿瘤、4例慢性胰腺炎、3例肿大淋巴结和1例胆囊癌。将从穿刺针推出的组织标本放入生理盐水中。灰白色、蠕虫状标本用于组织学诊断。其余标本进行离心，沉淀物涂片后由细胞病理学家检查以获得细胞学诊断。
25号针共进行了75次穿刺（平均1.6次），22号针共进行了69次穿刺（平均1.4次）。细胞学的总体组织采样率为100%（47/47），显著高于组织学的83%（39/47）（p = 0.01）。细胞学和组织学检查的总体诊断准确性分别为79%（37/47）和85%（33/39）（p = 0.48）。根据针型，25号针每次穿刺的细胞学和组织学组织采样率分别为97%（73/75）和56%（42/75），22号针分别为97%（67/69）和58%（40/69）；25号针每次穿刺的细胞学诊断准确性为73%（53/73），22号针为66%（44/67）（p = 0.
