Chen Dafan, Ren Yingchun, Chen Sumin, Jin Yubiao, Xie Haoran, Yu Lanting, Peng Kui, Xia Youchen, Pan Dan, Lu Jiawei, Lu Lungen, Wan Xinjian, Hu Duanmin, Li Baiwen
Department of Gastroenterology.
Department of Gastroenterology, Tongren Hospital.
J Clin Gastroenterol. 2023 Apr 1;57(4):417-422. doi: 10.1097/MCG.0000000000001700.
To comprehensively compare the wet suction technique with the conventional dry suction technique for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in solid lesions.
Optimal suction techniques for EUS-FNA remain uncertain when approaching solid lesions.
We performed a retrospective study of EUS-FNA at 3 medical centers in China. A total of 203 patients were enrolled who received 2 passes of EUS-FNA with 22-G needles. If the first pass underwent dry suction, the second pass was wet suction. Otherwise, the order of suction technique is opposite. Diagnostic accuracy, sample quality (including cellularity and blood contamination), and sample quantity (including specimen adequacy, the maximum intact specimen length, and the total specimen length) were compared between wet-suction and dry-suction techniques.
The patients included 143 pancreatic lesions and 60 nonpancreatic lesions. Compared with the dry suction technique, the wet suction technique yielded a significantly higher diagnostic accuracy (85.22% vs. 72.41%, P =0.002), better specimen adequacy score and cellularity score ( P <0.0001), and lower blood contamination score ( P <0.0001). In the subgroup analysis, wet suction provided significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis ( P <0.05), and better cellularity score and specimen adequacy score, lower blood contamination score, and longer maximum intact specimen length and total specimen length in various lesions than that in dry suction.
The wet suction technique resulted in significantly higher diagnostic accuracy in pancreatic cancer without chronic pancreatitis, and better cellularity and histologic specimen in most of solid lesions.
全面比较湿式抽吸技术与传统干式抽吸技术在实体病变内镜超声引导下细针穿刺活检（EUS-FNA）中的应用效果。
在处理实体病变时，EUS-FNA的最佳抽吸技术仍不明确。
我们在中国的3家医疗中心对EUS-FNA进行了一项回顾性研究。共纳入203例患者，这些患者接受了2次使用22G针的EUS-FNA。如果第一次穿刺采用干式抽吸，第二次穿刺则采用湿式抽吸。否则，抽吸技术的顺序相反。比较了湿式抽吸和干式抽吸技术在诊断准确性、样本质量（包括细胞数量和血液污染情况）以及样本量（包括标本充足性、最大完整标本长度和总标本长度）方面的差异。
患者包括143例胰腺病变和60例非胰腺病变。与干式抽吸技术相比，湿式抽吸技术的诊断准确性显著更高（85.22%对72.41%，P =0.002），标本充足性评分和细胞数量评分更好（P <0.0001），血液污染评分更低（P <0.0001）。在亚组分析中，湿式抽吸在无慢性胰腺炎的胰腺癌中诊断准确性显著更高（P <0.05），在各种病变中细胞数量评分和标本充足性评分更好，血液污染评分更低，最大完整标本长度和总标本长度比干式抽吸更长。
湿式抽吸技术在无慢性胰腺炎的胰腺癌中诊断准确性显著更高，在大多数实体病变中细胞数量和组织学标本更好。
