Division of Gastroenterology, Department of Medicine, University of New Mexico, Albuquerque, NM, 87111, USA.
Division of Gastroenterology, Department of Internal Medicine, University of New Mexico Health Sciences Center, MSC 10 550, Albuquerque, NM, 87111, USA.
Dig Dis Sci. 2022 Sep;67(9):4549-4556. doi: 10.1007/s10620-021-07316-4. Epub 2021 Dec 2.
Data on adequacy of EUS guided biopsies using different tissue acquisition techniques and fine needle aspiration needle designs have been inconclusive. Data on newer fine needle biopsy (FNB) needles are scarce. This study compared the performance of 3 acquisition techniques and 2 fine needle biopsy designs in solid pancreatic lesions.
Single-center, randomized, pilot clinical trial (Trial registration number NCT03264092). Patients undergoing EUS biopsy of pancreatic lesions were randomized to 1 of 3 acquisition techniques (dry suction, wet suction, slow pull) and 1 of 2 22G FNB needle designs. The primary outcome was specimen cellularity. Secondary outcomes included blood contamination and number of passes needed for diagnosis.
A total of 52 (35.3%), 49 (33.3%) and 46 (31.3%) specimens were obtained with slow pull, dry suction and wet suction, respectively. A total of 56 (38%) and 91 (62%) specimens were obtained with each needle, respectively. No difference in cellularity scores was identified by technique (3.28 vs 3.55 vs 2.94; p = 0.081) or needle type (3.45 vs 3.15; p = 0.19). The same was true for blood contamination and diagnostic pass. A diagnosis was reached after 3 passes in 51 patients (93%). Histological diagnosis was possible in 45 specimens (82%). No severe adverse events occurred.
Cellularity of pancreatic specimens obtained with FNB needles via EUS was not influenced by technique and needle design. Three passes were enough to obtain a histological diagnosis in most patients. Larger clinical trials are required to validate the results of this study.
使用不同的组织采集技术和细针抽吸针设计进行 EUS 引导下活检的充分性数据尚无定论。关于新型细针活检（FNB）针的数据很少。本研究比较了 3 种采集技术和 2 种 FNB 设计在实体胰腺病变中的性能。
单中心、随机、先导临床试验（试验注册号：NCT03264092）。接受 EUS 活检的胰腺病变患者被随机分为 3 种采集技术（干吸、湿吸、慢拉）和 2 种 22G FNB 针设计之一。主要结局是标本细胞数量。次要结局包括血液污染和获得诊断所需的穿刺次数。
分别用慢拉、干吸和湿吸获得 52（35.3%）、49（33.3%）和 46（31.3%）个标本。分别用每种针获得 56（38%）和 91（62%）个标本。技术（3.28 与 3.55 与 2.94；p=0.081）或针型（3.45 与 3.15；p=0.19）对细胞评分均无差异。血液污染和诊断穿刺也同样如此。51 例患者（93%）在 3 次穿刺后即可获得诊断。45 个标本（82%）可获得组织学诊断。无严重不良事件发生。
EUS 引导下 FNB 针获取的胰腺标本细胞数量不受技术和针设计的影响。大多数患者需要 3 次穿刺即可获得组织学诊断。需要更大规模的临床试验来验证本研究的结果。
