Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, India.
Endoscopy. 2013 Oct;45(10):792-8. doi: 10.1055/s-0033-1344217. Epub 2013 Sep 25.
Histological examination of core tissue samples may have advantages over cytology in endoscopic ultrasound (EUS)-guided sampling. We aimed to evaluate the feasibility and efficiency of a new 22G core biopsy needle.
Consecutive patients with a pancreatic mass lesion or peri-intestinal lymphadenopathy sequentially underwent fine needle biopsy with both a newly developed 22G core needle (the FNB needle) and a standard 22G fine needle aspiration (FNA) needle, in randomized order.
In 144 patients, mean age 48 years (± standard deviation [SD] 14; range 18 - 82), with 145 lesions (mean lesion size 39 ± 15 mm, range 15 - 99), EUS-guided sampling was technically feasible with both needles in all patients. Mean number of passes to obtain sufficient tissue was 1.2 ± 0.5 with the core needle vs. 2.5 ± 0.9 with the standard needle (P < 0.001). FNB specimens were adequate for evaluation in 125 (86.2 %) vs. 127 (87.6 %) with FNA (P = 0.72). Among 139 patients available for follow-up, FNB provided a correct diagnosis in 110 (79.1 %) and FNA in 112 (80.6 %) (P = 0.73). Sensitivity, specificity, positive and negative predictive values, and accuracy for diagnosis of malignancy were 90 %, 100 %, 100 %, 93 %, 96 % for FNB and 77 %, 100 %, 100 %, 85 %, 92 % for FNA, respectively (P > 0.05).
FNB with the new 22G core needle was technically feasible, efficient and comparable to FNA with a standard needle. The core needle required fewer passes to provide an adequate sample, offering potentially shorter procedure time.
与内镜超声（EUS）引导下的取样相比，对核心组织样本进行组织学检查可能具有优势。我们旨在评估一种新型 22G 核心活检针的可行性和效率。
连续的胰腺肿块或肠周淋巴结病变患者，依次顺序使用新开发的 22G 核心针（FNB 针）和标准的 22G 细针抽吸（FNA）针进行细针活检，以随机顺序进行。
在 144 例患者中，平均年龄为 48 岁（±标准偏差[SD] 14；范围 18-82），共有 145 个病变（平均病变大小为 39±15mm，范围 15-99），两种针均能在所有患者中进行技术上可行的 EUS 引导下取样。使用核心针获得足够组织的平均穿刺次数为 1.2±0.5 次，而标准针为 2.5±0.9 次（P<0.001）。FNB 标本可评估的比例为 125 例（86.2%）与 FNA 为 127 例（87.6%）（P=0.72）。在 139 例可随访的患者中，FNB 提供正确诊断的比例为 110 例（79.1%），FNA 为 112 例（80.6%）（P=0.73）。FNB 对恶性肿瘤的诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为 90%、100%、100%、93%、96%，而 FNA 分别为 77%、100%、100%、85%、92%（P>0.05）。
新型 22G 核心针的 FNB 在技术上是可行的、高效的，与标准针的 FNA 相当。核心针需要更少的穿刺次数来提供足够的样本，可能会缩短手术时间。
