Haseeb Abdul, Taylor Linda Jo, Adler Douglas G
Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Ann Gastroenterol. 2018 Nov-Dec;31(6):742-746. doi: 10.20524/aog.2018.0313. Epub 2018 Sep 24.
There has been a paradigm shift in tertiary centers from endoscopic ultrasound (EUS) fine-needle aspiration to EUS fine-needle biopsy (EUS-FNB) for tissue acquisition in solid lesions. While data exists on the use of FNB needles in solid pancreatic lesions, very few studies looked at the utility of FNB in solid extrapancreatic lesions. Our aim was to study and compare the technical success and feasibility of EUS-FNB in evaluating solid pancreatic and extrapancreatic lesions using a novel FNB needle.
We performed a retrospective cohort study of patients with solid masses or lesions needing EUS-guided core biopsy at the University of Utah between May 2016 and November 2017. All core biopsies were obtained using an Acquire™Fine Needle Biopsy Device (Boston Scientific Corporation, Natick MA, USA). Rapid on-site evaluation was performed by a board-certified cytopathologist in all cases.
One hundred thirty-two patients (87 male) were included. Ninety-nine (73.3%) of the lesions were located in the pancreas. All needle sizes (19 G, 22 G and 25 G) had similar yield. The mean number of passes needed was 2.28±0.7. EUS-FNB of the pancreatic lesions had a diagnostic accuracy of 97.9%, comparable to the 97.2% for the biopsied extra-pancreatic lesions. Only 3 of 132 cases needed re-biopsy at a later date. No immediate adverse events were reported.
In this large, single-center study, EUS-FNB with a novel Franseen-design needle was proven to be an effective modality for tissue acquisition from both pancreatic and extrapancreatic solid lesions.
在三级医疗中心，对于实体病变的组织获取，已从内镜超声（EUS）细针穿刺抽吸转向EUS细针活检（EUS-FNB）。虽然有关于FNB针在实性胰腺病变中应用的数据，但很少有研究探讨FNB在胰腺外实性病变中的效用。我们的目的是研究并比较使用新型FNB针进行EUS-FNB评估实性胰腺和胰腺外病变的技术成功率和可行性。
我们对2016年5月至2017年11月在犹他大学需要进行EUS引导下粗针活检的实性肿块或病变患者进行了一项回顾性队列研究。所有粗针活检均使用Acquire™细针活检装置（美国马萨诸塞州纳蒂克市波士顿科学公司）进行。所有病例均由一名经过委员会认证的细胞病理学家进行快速现场评估。
纳入132例患者（87例男性）。99例（73.3%）病变位于胰腺。所有针径（19G、22G和25G）的取材成功率相似。所需的平均穿刺次数为2.28±0.7次。胰腺病变的EUS-FNB诊断准确率为97.9%，与胰腺外活检病变的97.2%相当。132例病例中只有3例需要在以后重新活检。未报告立即发生的不良事件。
在这项大型单中心研究中，使用新型 Franseen 设计针的 EUS-FNB 被证明是从胰腺和胰腺外实性病变获取组织的有效方式。
