Department of Gastroenterology, Fukushima Medical University, School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
BMC Cancer. 2020 Nov 11;20(1):1094. doi: 10.1186/s12885-020-07588-5.
The efficacy of immune checkpoint blockade in the treatment of microsatellite instability (MSI)-high tumors was recently reported. Therefore, the acquisition of histological specimens is desired in cases of unresectable solid pancreatic lesions (UR SPLs). This study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for UR SPL tissue acquisition and MSI evaluation.
A total of 195 SPL patients who underwent EUS-guided fine-needle aspiration (EUS-FNA) or EUS-FNB (EUS-FNAB) between January 2017 and March 2020 were enrolled in this study. Among them, 89 SPL patients (FNB: 28, FNA: 61) underwent EUS-FNAB using a 22-G needle (UR SPLs: 58, FNB: 22, FNA: 36) (UR SPLs after starting MSI evaluation: 23, FNB: 9, FNA: 14).
The puncture number was significantly lower with FNB than with FNA (median (range): 3 (2-5) vs 4 (1-8), P < 0.01, UR SPLs: 3 (2-5) vs 4 (1-8), P = 0.036). Histological specimen acquisition was more commonly achieved with FNB than with FNA (92.9% (26/28) vs 68.9% (42/61), P = 0.015, UR SPLs: 100% (22/22) vs 72.2% (26/36), P < 0.01). The histological specimen required for MSI evaluation was acquired more often with FNB than with FNA (88.9% (8/9) vs 35.7% (5/14), P = 0.03).
EUS-FNB using a Franseen needle is efficient for histological specimen acquisition and sampling the required amount of specimen for MSI evaluation in UR SPL patients.
免疫检查点阻断在治疗微卫星不稳定（MSI）高肿瘤方面的疗效最近得到了报道。因此，对于无法切除的实体胰腺病变（UR SPL），需要获取组织学标本。本研究探讨了使用 Franseen 针进行内镜超声引导下细针活检（EUS-FNB）获取 UR SPL 组织和 MSI 评估的效果。
本研究共纳入 2017 年 1 月至 2020 年 3 月期间接受 EUS 引导下细针抽吸（EUS-FNA）或 EUS-FNB（EUS-FNAB）的 195 例 SPL 患者。其中，89 例 SPL 患者（FNB：28 例，FNA：61 例）接受了 22-G 针 EUS-FNAB（UR SPLs：58 例，FNB：22 例，FNA：36 例）（开始 MSI 评估后 UR SPLs：23 例，FNB：9 例，FNA：14 例）。
FNB 的穿刺次数明显低于 FNA（中位数（范围）：3（2-5）比 4（1-8），P < 0.01，UR SPLs：3（2-5）比 4（1-8），P = 0.036）。FNB 比 FNA 更常获得组织学标本（92.9%（26/28）比 68.9%（42/61），P = 0.015，UR SPLs：100%（22/22）比 72.2%（26/36），P < 0.01）。FNB 比 FNA 更常获得 MSI 评估所需的组织学标本（88.9%（8/9）比 35.7%（5/14），P = 0.03）。
在 UR SPL 患者中，使用 Franseen 针的 EUS-FNB 可有效获取组织学标本，并采集足够量的标本进行 MSI 评估。
