Soltani Amin K, Krishnan Kumar
Department of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Am Soc Cytopathol. 2020 Sep-Oct;9(5):389-395. doi: 10.1016/j.jasc.2020.05.006. Epub 2020 Jun 5.
Endoscopic ultrasound-guided tissue acquisition is now an imperative technique for the diagnosis of multiple diseases in the gastrointestinal tract and nearby structures. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and fine needle biopsy via dedicated FNB needles (EUS-FNB) are two standard-essential tools for tissue acquisition. The choice of needle type is an important factor determining appropriate tissue acquisition. Multiple studies have compared EUS-FNA versus EUS-FNB on different lesions also there are several studies evaluated different needles in terms of sampling adequacy and cytological and histological accuracy. Prior studies comparing prior-generation FNB needles to FNA did not show an increased diagnostic yield with FNB. However, the newer-generation needles have demonstrated enhanced performance compared with their predecessors. As they may provide a large amount of tissue for the cytological and histological evaluation, rapid onsite specimen evaluation (ROSE), and immunohistochemical and molecular analyses, which may be very important for targeted therapy. In this review, we discuss current evidence and literature on the use of the newer generation needles for pancreatic and non-pancreatic lesions.
内镜超声引导下组织获取现已成为诊断胃肠道及附近结构多种疾病的一项必要技术。内镜超声引导下细针穿刺抽吸术（EUS-FNA）以及通过专用FNB针进行的细针活检（EUS-FNB）是组织获取的两项标准基本工具。针型的选择是决定能否获取合适组织的一个重要因素。多项研究比较了EUS-FNA与EUS-FNB在不同病变中的应用，也有几项研究从采样充分性以及细胞学和组织学准确性方面评估了不同的针。先前将前代FNB针与FNA进行比较的研究并未显示FNB的诊断率有所提高。然而，新一代针已显示出比其前代产品性能有所增强。因为它们可能为细胞学和组织学评估、快速现场标本评估（ROSE）以及免疫组化和分子分析提供大量组织，而这些对于靶向治疗可能非常重要。在本综述中，我们讨论了关于使用新一代针用于胰腺和非胰腺病变的当前证据和文献。
