使用25号和22号粗针活检针在内镜超声引导下获取实性胰腺肿块组织的前瞻性比较研究。
Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses.
作者信息
Park Se Woo, Chung Moon Jae, Lee Sang Hoon, Lee Hee Seung, Lee Hyun Jik, Park Jeong Yup, Park Seung Woo, Song Si Young, Kim Hoguen, Chung Jae Bock, Bang Seungmin
机构信息
Division of Gastroenterology, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Korea.
Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
出版信息
PLoS One. 2016 May 5;11(5):e0154401. doi: 10.1371/journal.pone.0154401. eCollection 2016.
BACKGROUND AND AIMS
Although thicker needles theoretically allow more tissue to be collected, their decreased flexibility can cause mechanical damage to the endoscope, technical failure, and sample blood contamination. The effects of needle gauge on diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) of pancreatic mass lesions remain unknown. This study compared procurement rates of histologic cores obtained from EUS-FNB of pancreatic masses using 25- and 22-gauge core biopsy needles.
PATIENTS AND METHODS
From March 2014 to July 2014, 66 patients with solid pancreatic mass underwent EUS-FNB with both 25- and 22-gauge core biopsy needles. Among them, 10 patients were excluded and thus 56 patients were eligible for the analyses. Needle sequences were randomly assigned, and two passes were made with each needle, consisting of 10 uniform to-and-fro movements on each pass with 10 mL syringe suction. A pathologist blinded to needle sequence evaluated specimens for the presence of histologic core.
RESULTS
The mean patient age was 65.8 ± 9.5 years (range, 44-89 years); 35 patients (62.5%) were men. The mean pancreatic mass size was 35.3 ± 17.1 mm (range 14-122.3 mm). Twenty-eight patients (50%) had tumors at the pancreas head or uncinate process. There were no significant differences in procurement rates of histologic cores between 25-gauge (49/56, 87.5%) and 22-gauge (46/56, 82.1%, P = 0.581) needles or diagnostic accuracy using only histologic cores (98% and 95%). There were no technical failures or procedure-related adverse events.
CONCLUSIONS
The 25-gauge core biopsy needle could offer acceptable and comparable outcomes regarding diagnostic performance including histologic core procurement rates compared to the 22-gauge core biopsy needle, although the differences were not statistically significant.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01795066.
背景与目的
尽管理论上较粗的针能采集更多组织，但针的柔韧性降低会对内窥镜造成机械损伤、导致技术失败以及样本血液污染。针的规格对胰腺肿块病变的内镜超声引导下细针穿刺活检（EUS-FNB）诊断结果的影响尚不清楚。本研究比较了使用25号和22号活检针从胰腺肿块的EUS-FNB获取组织芯的成功率。
患者与方法
2014年3月至2014年7月，66例胰腺实性肿块患者接受了25号和22号活检针的EUS-FNB。其中，10例患者被排除，因此56例患者符合分析条件。针的顺序随机分配，每根针进行两次穿刺，每次穿刺包括10次均匀的来回移动，同时用10 mL注射器抽吸。一名对针顺序不知情的病理学家评估标本中是否存在组织芯。
结果
患者平均年龄为65.8±9.5岁（范围44 - 89岁）；35例患者（62.5%）为男性。胰腺肿块平均大小为35.3±17.1 mm（范围14 - 122.3 mm）。28例患者（50%）的肿瘤位于胰头或钩突。25号针（49/56，87.5%）和22号针（46/56，82.1%，P = 0.581）获取组织芯的成功率或仅使用组织芯的诊断准确性之间无显著差异。未发生技术失败或与操作相关的不良事件。
结论
与22号活检针相比，25号活检针在包括组织芯获取率在内的诊断性能方面可提供可接受且相当的结果，尽管差异无统计学意义。
试验注册
ClinicalTrials.gov NCT01795066
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