Kin Toshifumi, Katanuma Akio, Yane Kei, Takahashi Kuniyuki, Osanai Manabu, Takaki Ryo, Matsumoto Kazuyuki, Gon Katsushige, Matsumori Tomoaki, Tomonari Akiko, Maguchi Hiroyuki, Shinohara Toshiya, Nojima Masanori
Center for Gastroenterology, Teine-Keijinkai Hospital , 1-40/1-12 Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555 , Japan.
Scand J Gastroenterol. 2015 Jul;50(7):900-7. doi: 10.3109/00365521.2014.983155. Epub 2015 Mar 2.
Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) using the slow pull technique (SP-FNA) has recently attracted attention as an effective tissue acquisition technique. However, efficacy of SP-FNA with a 22-gauge conventional needle remains unclear. The aim of this study is to evaluate the diagnostic ability of SP-FNA with a 22-gauge needle.
Patients with a pancreatic solid lesion were prospectively enrolled in this study. SP-FNA was performed at two needle passes with a 22-gauge needle. One dedicated pathologist evaluated the obtained samples in terms of quantity (Grade 0: scant; Grade 1: inadequate; Grade 2: adequate), quality (Grade 0: poor; Grade 1: moderate; Grade 2: good), and blood contamination (Grade 0: significant; Grade 1: moderate; Grade 2: low), and provided a pathological diagnosis. Additional EUS-FNA was performed by applying suction (SA-FNA). The evaluation points were as follows: diagnostic accuracy of SP-FNA compared with that of SA-FNA, and the quantity, quality, and blood contamination level of SP-FNA-obtained samples.
We enrolled 40 cases. The diagnostic accuracy of SP-FNA was 90% (36/40). There was no significant difference in the accuracy between SP-FNA and SA-FNA (90% vs. 90%, p = 1.000). The samples obtained using SP-FNA were assessed as Grade 2 for quantity in 29 cases (73%), quality in 31 (78%), and blood contamination in 25 (63%).
Adequate, high-quality, and unsubstantially blood-contaminated samples could be obtained using SP-FNA. The diagnostic ability of SP-FNA was 90%, which appeared to be similar to that of SA-FNA.
使用慢拉技术（SP-FNA）的超声内镜引导下细针穿刺抽吸术（EUS-FNA）作为一种有效的组织获取技术，近来备受关注。然而，22G传统穿刺针行SP-FNA的有效性仍不明确。本研究旨在评估22G穿刺针行SP-FNA的诊断能力。
前瞻性纳入胰腺实性病变患者。使用22G穿刺针进行两次穿刺行SP-FNA。由一名专业病理学家评估获取样本的数量（0级：少量；1级：不足；2级：充足）、质量（0级：差；1级：中等；2级：好）和血液污染情况（0级：严重；1级：中等；2级：低），并给出病理诊断。通过施加负压进行额外的EUS-FNA（SA-FNA）。评估要点如下：SP-FNA与SA-FNA相比的诊断准确性，以及SP-FNA获取样本的数量、质量和血液污染水平。
我们纳入了40例患者。SP-FNA的诊断准确性为90%（36/40）。SP-FNA与SA-FNA的准确性无显著差异（90%对90%，p = 1.000）。使用SP-FNA获取的样本，数量评估为2级的有29例（73%），质量评估为2级的有31例（78%），血液污染评估为2级的有25例（63%）。
使用SP-FNA可获得充足、高质量且血液污染少的样本。SP-FNA的诊断能力为90%，似乎与SA-FNA相似。
