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新型叉尖针与标准针用于内镜超声引导下从上消化道实体肿块获取组织:一项匹配队列研究。

Novel fork-tip needles versus standard needles for EUS-guided tissue acquisition from solid masses of the upper GI tract: a matched cohort study.

作者信息

Jovani Manol, Abidi Wasif M, Lee Linda S

机构信息

a Clinical and Translational Epidemiology Unit, Division of Gastroenterology , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA.

b Division of Gastroenterology, Hepatology and Endoscopy , Brigham and Women's Hospital and Harvard Medical School , Boston , MA , USA.

出版信息

Scand J Gastroenterol. 2017 Jun-Jul;52(6-7):784-787. doi: 10.1080/00365521.2017.1306879. Epub 2017 Mar 30.

Abstract

BACKGROUND

There are very few available data on the novel SharkCore™ needles for EUS-FNB.

AIM

Comparison of the performance of the SharkCore™ needles with the standard EUS-FNA needles for the diagnosis of solid upper GI masses.

PATIENTS AND METHODS

Single-center, retrospective cohort study in an academic tertiary referral hospital. Patients were matched 1:1 for the site of the lesion and the presence or absence of rapid on-site evaluation (ROSE).

RESULTS

A total of 102 patients were included. There was no statistically significant difference in the mean number of passes (3.3 ± 1.3 versus 3.4 ± 1.5; p = .89). Similar results were observed at the subgroup with ROSE (4.3 ± 1.3 versus 3.7 ± 1.5; p = .26). More histological specimens were obtained with the SharkCore™ needles compared to standard needles (59 versus 5%; p < .001). Diagnostic test characteristics were not significantly different (sensitivity: 91.5 versus 85.7; specificity: 100 versus 100%; accuracy: 92.2 versus 85.4% for SharkCore™ versus standard needles, p > .05 in all cases). At multivariable analysis, there was no statistically significant difference in the mean number of passes in all patients (p = .23) and in the ROSE subgroup (p = .66). However, the SharkCore™ needle obtained significantly more histological material than the standard needle (odds ratio 66; 95% confidence interval: 11.8, 375.8, p < .001). There was no significant difference in complication rates (p = .5).

LIMITATIONS

Retrospective study, single-center.

CONCLUSION

The SharkCore needles were similar to standard FNA needles in terms of the number of passes to reach diagnosis, but obtained significantly more histological specimen.

摘要

背景

关于用于超声内镜引导下细针穿刺活检(EUS-FNB)的新型SharkCore™针的可用数据非常少。

目的

比较SharkCore™针与标准EUS-FNA针在诊断上消化道实体肿物方面的性能。

患者与方法

在一家学术性三级转诊医院进行的单中心回顾性队列研究。根据病变部位和是否存在快速现场评估(ROSE)将患者1:1配对。

结果

共纳入102例患者。穿刺次数的平均值无统计学显著差异(3.3±1.3对3.4±1.5;p = 0.89)。在有ROSE的亚组中观察到类似结果(4.3±1.3对3.7±1.5;p = 0.26)。与标准针相比,SharkCore™针获得的组织学标本更多(59%对5%;p < 0.001)。诊断试验特征无显著差异(敏感性:91.5%对85.7%;特异性:100%对100%;准确性:92.2%对85.4%,SharkCore™针与标准针相比,所有情况p > 0.05)。在多变量分析中,所有患者穿刺次数的平均值无统计学显著差异(p = 0.23),在ROSE亚组中也无显著差异(p = 0.66)。然而,SharkCore™针获得的组织学材料明显多于标准针(比值比66;95%置信区间:11.8,375.8,p < 0.001)。并发症发生率无显著差异(p = 0.5)。

局限性

回顾性研究,单中心。

结论

在达到诊断所需的穿刺次数方面,SharkCore针与标准FNA针相似,但获得的组织学标本明显更多。

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