Internal Medicine, Ochsner Clinic Foundation, New Orleans, LA, USA.
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, 46202-3082, USA.
Dig Dis Sci. 2021 Jan;66(1):238-246. doi: 10.1007/s10620-020-06165-x. Epub 2020 Mar 3.
Data on comparative efficacy of various available endoscopic ultrasound-guided liver biopsy (EUS-LB) needles are limited. We sought to compare the performance of a novel Franseen-tip 22G fine-needle biopsy (FNB) device to that of 19G needle platforms for liver parenchyma.
Consecutive patients referred for EUS and suspected to have hepatic parenchymal disease underwent EUS-LB using different EUS needles and were included in this retrospective study. Two blinded expert liver pathologists independently reviewed and reported on: total number of tissue fragments, length of longest fragment, number of complete and incomplete portal tracts (CPT and IPT), and specimen adequacy.
A 22G Franseen-tip needle (A) was used in 30 patients; 19G Tru-Cut needle (B) in 50 patients; 19G reverse beveled non-Tru-Cut needle (C) in 27 patients; and a 19G flexible non-Tru-Cut needle (D) in 28 patients. In the order of needles, A, B, C and D, > 10 tissue fragments were obtained in 100%, 6%, 82%, and 96% samples, the mean number of CPTs was 6.9; 3.0; 7.3; and 16.9, length of longest fragment was 3.8, 4. 7, 3.9, and 8.4 mm, and specimen adequacy was 66.7%, 46%, 82.1%, and 81.5%, respectively. A positive correlation was obtained between number of CPTs and length of longest fragment in samples accrued by 19G needles.
EUS-LB specimens using 22G Franseen-tip needle appear highly fragmented, leading to inferior specimen adequacy compared to 19G non-Tru-Cut needles. We also report on using length of longest fragment as an additional criterion for specimen adequacy as it positively correlates with number of CPTs standard.
目前关于各种可用的内镜超声引导下肝活检（EUS-LB）针的比较疗效的数据有限。我们旨在比较新型 Franseen 尖端 22G 细针活检（FNB）装置与 19G 针平台在肝实质方面的性能。
连续入组因 EUS 检查并疑似肝实质疾病而行 EUS-LB 的患者，并纳入本回顾性研究。两名盲法肝脏病理学家独立回顾和报告：总组织碎片数量、最长碎片长度、完整和不完整门脉通道（CPT 和 IPT）的数量以及标本充足性。
30 例患者使用 22G Franseen 尖端针（A）；50 例患者使用 19G Tru-Cut 针（B）；27 例患者使用 19G 反向斜面非 Tru-Cut 针（C）；28 例患者使用 19G 弹性非 Tru-Cut 针（D）。按针的顺序 A、B、C 和 D，100%、6%、82%和 96%的样本获得>10 个组织碎片，CPT 的平均数量分别为 6.9；3.0；7.3；16.9，最长碎片长度分别为 3.8；4.7；3.9；8.4mm，标本充足性分别为 66.7%；46%；82.1%；81.5%。19G 针采集的样本中，CPT 的数量与最长碎片的长度之间存在正相关。
与 19G 非 Tru-Cut 针相比，EUS-LB 标本使用 22G Franseen 尖端针时碎片高度破碎，导致标本充足性较差。我们还报告了使用最长碎片长度作为标本充足性的附加标准，因为它与 CPT 数量呈正相关。
