在 EUS-FNA/B 中引入带有核心捕捉器的 20 号活检针对诊断胰腺癌的效果。
Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer.
机构信息
Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan.
Department of Gastroenterology and Hepatology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
出版信息
BMC Gastroenterol. 2021 Jan 6;21(1):8. doi: 10.1186/s12876-020-01583-7.
BACKGROUND
Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015.
METHODS
We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients' clinical characteristics and the diagnostic accuracy and safety of each needle.
RESULTS
A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1 ± 2.2 mm) than PC20 (30.6 ± 0.7 mm, p < 0.01) and PC22 (30.3 ± 0.8 mm, p < 0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj) < 0.0001) and 75.0% with the AC22 (p-adj = 0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj < 0.0001) and 91.7% with the AC22 (p-adj > 0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles.
CONCLUSIONS
The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.
背景
内镜超声引导下细针抽吸/活检（EUS-FNA/B）是胰腺实性病变病理诊断的标准方法。EchoTip ProCore 20G®（PC20）是一种 20 号活检针，带有前斜面核心捕捉器，自 2015 年以来在日本上市。
方法
我们比较了 PC20 与 EchoTip ProCore 22G®（PC22）和 Acquire 22G®（AC22）在 EUS-FNA/B 诊断胰腺癌中的疗效。这项回顾性研究纳入了 2013 年 4 月至 2019 年 10 月在我院接受 EUS-FNA/B 检查的 191 例胰腺癌患者，这些患者分别使用了 PC20、PC22 或 AC22。我们研究了患者的临床特征以及每种针的诊断准确性和安全性。
结果
所有患者均获得了足够的穿刺行程长度。AC22 的最大超声下长度最短（22.1±2.2 mm），低于 PC20（30.6±0.7 mm，p<0.01）和 PC22（30.3±0.8 mm，p<0.01）。PC20 的组织学准确性为 96.4%，但 PC22 仅为 58.8%（调整后的 p（p-adj）<0.0001），AC22 为 75.0%（p-adj=0.06）。PC20 的组织学和细胞学联合诊断准确性为 96.4%，PC22 为 72.1%（p-adj<0.0001），AC22 为 91.7%（p-adj>0.99）。PC20 组有 1 例（0.9%）患者发生轻度胰腺炎，但其他针均未发生不良事件。
结论
PC20 比 PC22 具有更好的诊断能力。PC20 和 AC22 的诊断效果相似。PC20 的高组织学准确性可能有利于对组织学评估至关重要的病变。
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