Department of Gastroenterology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Department of Endoscopy and Endoscopic Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
J Gastroenterol Hepatol. 2021 Oct;36(10):2754-2761. doi: 10.1111/jgh.15534. Epub 2021 May 14.
While encouraging data of endoscopic ultrasound (EUS)-guided fine-needle biopsy (EUS-FNB) using a 22-gauge Franseen needle have been reported, large-scale data of per pass and quantitative analyses are still lacking.
This was a multicenter prospective study of EUS-FNB using the 22-gauge Franseen needle for a pancreatic solid lesion. Cytological and histological analyses per pass were evaluated and semi-quantitative analyses were performed on core tissue and blood contamination. Primary end-point was diagnostic accuracy per session. Prognostic factors were analyzed for diagnostic accuracy, sensitivity, core tissue, and blood contamination.
A total of 629 passes were performed in 244 cases at 14 centers between 2018 and 2019. The median tumor size was 29 mm, and the puncture was transduodenal in 43%. The median pass number was 2. Diagnostic accuracy per session, at a first pass, and per pass were 93%, 90%, and 88%. In 198 cases with pancreatic cancer, diagnostic sensitivity per session, at a first pass, and per pass were 94%, 89%, and 89%. The rates of core tissue score of 4 and blood contamination score of 3 were 50% and 47%. The adverse event rate was 1.6%. In the multivariate analysis, tumor size ≤20 mm (odds ratio [OR] of 0.46, P = 0.03), transduodenal puncture (OR of 0.53, P = 0.04), and suction (OR of 0.16, P = 0.01) were associated with lower diagnostic accuracy.
The EUS-FNB using the 22-gauge Franseen needle for pancreatic solid lesions showed high per pass and overall diagnostic accuracy.
虽然已经报道了使用 22 号 Franseen 针进行内镜超声（EUS）引导下细针活检（EUS-FNB）的数据，但仍缺乏每针和定量分析的大规模数据。
这是一项使用 22 号 Franseen 针对胰腺实性病变进行 EUS-FNB 的多中心前瞻性研究。每针进行细胞学和组织学分析，并对核心组织和血液污染进行半定量分析。主要终点为每针的诊断准确性。对诊断准确性、敏感性、核心组织和血液污染进行了预后因素分析。
2018 年至 2019 年，在 14 个中心的 244 例患者中进行了 629 次穿刺。中位肿瘤大小为 29mm，43%为经十二指肠穿刺。中位穿刺次数为 2 次。初次穿刺、每针的诊断准确性分别为 93%、90%和 88%。在 198 例胰腺癌患者中，初次穿刺、每针的诊断敏感性分别为 94%、89%和 89%。核心组织评分 4 分和血液污染评分 3 分的比例分别为 50%和 47%。不良事件发生率为 1.6%。在多变量分析中，肿瘤大小≤20mm（比值比[OR]为 0.46，P=0.03）、经十二指肠穿刺（OR 为 0.53，P=0.04）和抽吸（OR 为 0.16，P=0.01）与较低的诊断准确性相关。
使用 22 号 Franseen 针对胰腺实性病变进行 EUS-FNB 显示出较高的每针和总体诊断准确性。
Zotero 插件