新型细针活检装置用于超声内镜引导下实体病变采样性能的前瞻性评估。

Prospective Assessment of the Performance of a New Fine Needle Biopsy Device for EUS-Guided Sampling of Solid Lesions.

作者信息

El Hajj Ihab I, Wu Howard, Reuss Sarah, Randolph Melissa, Harris Akeem, Gromski Mark A, Al-Haddad Mohammad

机构信息

Division of Gastroenterology, Section of Interventional Endoscopy, USA.

Department of Laboratory Medicine and Cytopathology, Indiana University School of Medicine, Indianapolis, IN, USA.

出版信息

Clin Endosc. 2018 Nov;51(6):576-583. doi: 10.5946/ce.2018.053. Epub 2018 Jul 13.

BACKGROUND/AIMS: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique.

METHODS

Acquire® 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using Expect® 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis.

RESULTS

Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain.

CONCLUSION

The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.

背景/目的：超声内镜引导下细针穿刺抽吸术（EUS-FNA）仍然是最常见的超声内镜引导下组织获取技术。本研究旨在评估一种新型 Franseen 尖端细针活检（FNB）装置在超声内镜引导下对实性病变进行采样的性能，并将其与传统的 FNA 技术进行比较。

方法

使用 Acquire® 22G FNB 针（美国马萨诸塞州纳蒂克市波士顿科学公司）对实体瘤进行采样（研究组）。收集组织进行快速现场评估，并制作触摸涂片和压片标本。使用 Expect® 22G FNA 针（波士顿科学公司）获得的既往 EUS-FNA 样本用作对照（对照组）。所有标本均由两名对正式细胞病理学诊断不知情的细胞病理学家独立评估。

结果

FNB 组（51 个样本）的平均细胞块组织学评分显著更高（p = 0.046），尽管与 FNA 组（50 个标本）相比，平均穿刺次数显著更低（p < 0.001）。FNB 组与 FNA 组的总体诊断率分别为 96%和 88%。FNB 组所有符合细胞块标准的病变中肿瘤分化程度均得到充分评估。两名患者在 FNB 后出现腹痛。