Barresi Luca, Tarantino Ilaria, Traina Mario, Granata Antonino, Curcio Gabriele, Azzopardi Neville, Baccarini Paola, Liotta Rosa, Fornelli Adele, Maimone Antonella, Jovine Elio, Cennamo Vincenzo, Fabbri Carlo
Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
Gastroenterology and Endoscopy Unit, ISMETT, Palermo, Italy.
Dig Liver Dis. 2014 Jan;46(1):45-50. doi: 10.1016/j.dld.2013.06.008. Epub 2013 Jul 31.
Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available.
We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions.
58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration.
Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications.
Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate.
内镜超声引导下细针穿刺的细胞学诊断敏感性和充分性较低。一种新设计的带有侧孔的内镜超声引导下细针活检装置现已可用。
我们开展了一项研究，旨在评估带有侧孔的22G针用于内镜超声引导下胰腺囊性病变细针穿刺和活检的可行性、安全性及诊断率。
一项前瞻性、双中心研究纳入了58例连续接受内镜超声引导下细针穿刺的患者，共60个胰腺囊性病变，采用带有侧孔的22G针进行细针穿刺和活检。
细针穿刺和活检在所有病例中技术上均可行。在60个胰腺囊性病变中，39个（65%）的标本足以进行细胞组织学评估。在有实性成分的病变和恶性病变中，充分率分别为94.4%（p = 0.0149）和100%（p = 0.0069）。18/39（46.1%）的病例样本足以进行组织学评估。仅出现2例（3.3%）轻度并发症。
使用带有侧孔的22G针进行细针穿刺和活检是可行的，且优于传统的内镜超声引导下从囊液中进行细针穿刺细胞学检查，特别是对于有实性成分或恶性的胰腺囊性病变，诊断率更高且并发症发生率未增加。
