新的 Procore 20G 双向前斜口套管针能否通过内镜超声诊断实性胰腺病变获得更好的组织学样本？
IS THE NEW PROCORE 20G DOUBLE FORWARD-BEVEL NEEDLE CAPABLE TO OBTAIN BETTER HISTOLOGICAL SAMPLES BY ENDOSCOPIC ULTRASOUND FOR DIAGNOSING SOLID PANCREATIC LESIONS?
机构信息
Division of Gastrointestinal Surgery (Endoscopy Unit), Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Hospital das Clínicas, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
出版信息
Arq Bras Cir Dig. 2021 Jan 25;33(4):e1554. doi: 10.1590/0102-672020200004e1554. eCollection 2021.
BACKGROUND
Fine needle biopsy (FNB) histological samples by endoscopic ultrasound. It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined.
AIM
To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy.
METHODS
This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist.
RESULTS
The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively.
CONCLUSIONS
The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.
背景
内镜超声引导下细针活检（FNB）组织学样本。对于没有明确切除指征的实性胆胰病变，获得有代表性的组织学样本非常重要。在这种情况下，新针的作用尚待确定。
目的
比较 20G 双针细针活检（FNB）和传统 22G 细针抽吸（FNA）针在内镜超声（EUS）引导下活检中的性能评估。
方法
这项前瞻性研究对 20 例接受两种针随机穿刺胰腺实性病变的患者进行了研究，并由一名病理学家对组织样本进行了分析。
结果
ProCore 20G FNB 针提供了更多的足够组织样本（16 针比 9 针，p=0.039），细胞定量评分更好（11 针比 5 针，p=0.002），组织学样本直径更大（1.51±1.3mm 比 0.94±0.55mm，p=0.032），比 22G 针。两组间的技术成功率、穿刺难度和样本出血情况相似。20G 和 22G 针的敏感性、特异性和诊断准确性分别为 88.9%、100%和 90%和 77.8%、100%和 78.9%。
结论
ProCore 20G FNB 获得的样本具有更好的组织学参数；虽然两种针的诊断性能没有差异，但这些发现可能会提高病理学家的表现。
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