Digestive Endoscopy Unit, Catholic University, Rome, Italy.
Digestive Endoscopy Unit, Catholic University, Rome, Italy; Gastroenterology and Internal Medicine Departments, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania.
Dig Liver Dis. 2018 May;50(5):469-474. doi: 10.1016/j.dld.2018.01.128. Epub 2018 Feb 8.
Procurement of tissue core biopsy may overcome some of the limitations of EUS-FNA. We aimed at assessing the safety, core procurement yield and diagnostic accuracy of two novel available histology needles.
Data from consecutive patients with solid lesions who underwent EUS-FNB using the 25G-22G SharkCore™ needles were retrieved from 4 tertiary-care centers database.
146 patients (mean age 64 ± 12 years; M/F, 76/68) with 156 lesions (114 pancreatic) were identified. In 83 cases the 22G needle was used. 3.6 ± 1.2 passes per lesion were performed, without any major complications. A core biopsy was procured in 89.1% of cases. Considering malignant vs. non-malignant disease, the sensitivity, specificity, negative likelihood ratio, positive likelihood ratio, and diagnostic accuracy were 90.2% (95% CI, 83.7-94.3), 100% (95% CI, 87.2-100), 0.099 (95% CI, 0.058-0.170), 60.4 (95% CI, 3.86-947.4), and 92.3% (95% CI, 88.1-96.5). Procurement yield was significantly higher for the 22G (95.2% vs. 82.2%, p = 0.011), despite the fact that more needle passes were performed with the 25G needle (3.8 ± 1.3 vs. 3.4 ± 1.0, p = 0.028).
EUS-FNB using the 25G-22G SharkCore™ needles is able to reach a very good procurement yield and diagnostic accuracy. The 22G-size needle showed superior core procurement and diagnostic capabilities. Large prospective studies are warranted to further evaluate the use of these types of needles.
组织芯活检的获取可能克服了 EUS-FNA 的一些局限性。我们旨在评估两种新型可用组织学针的安全性、核心获取产量和诊断准确性。
从 4 个三级护理中心的数据库中检索了连续接受 EUS-FNB 治疗的实体病变患者的数据，这些患者使用了 25G-22G SharkCore™ 针。
共确定了 146 例（平均年龄 64±12 岁；M/F，76/68）患者的 156 个病灶（114 个胰腺）。在 83 例中使用了 22G 针。每个病变进行了 3.6±1.2 次穿刺，没有出现任何重大并发症。89.1%的病例获取了核心活检。考虑到恶性与非恶性疾病，敏感性、特异性、负似然比、正似然比和诊断准确性分别为 90.2%（95%CI，83.7-94.3）、100%（95%CI，87.2-100）、0.099（95%CI，0.058-0.170）、60.4（95%CI，3.86-947.4）和 92.3%（95%CI，88.1-96.5）。22G 针的获取产量明显更高（95.2% vs. 82.2%，p=0.011），尽管使用 25G 针进行了更多的针次（3.8±1.3 vs. 3.4±1.0，p=0.028）。
使用 25G-22G SharkCore™ 针进行 EUS-FNB 能够达到非常好的获取产量和诊断准确性。22G 尺寸的针具有更好的核心获取和诊断能力。需要进行大型前瞻性研究来进一步评估这些类型的针的使用。
