内镜超声引导下组织采集(EUS-FNA)与 EUS-FNB 对无 ROSE 的胰腺实性肿块的诊断性能：一项回顾性研究。
Diagnostic performance of endoscopic ultrasound-guided tissue acquisition by EUS-FNA versus EUS-FNB for solid pancreatic mass without ROSE: a retrospective study.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand.
NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
出版信息
World J Surg Oncol. 2022 Jun 24;20(1):215. doi: 10.1186/s12957-022-02682-3.
BACKGROUND
Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is an established diagnostic procedure for solid pancreatic mass. However, the diagnostic yield between fine-needle aspiration (FNA) and fine-needle biopsy (FNB) remains unclear. We aimed to evaluate and compare the diagnostic yields between FNA and FNB using conventional FNA and Franseen needles of the same size 22-gauge needle, in patients with solid pancreatic mass who underwent EUS-TA without rapid onsite cytopathology evaluation (ROSE).
METHODS
All cases of EUS-TA by FNA or FNB for solid pancreatic mass between January 2017 and October 2020 in a single-centre university hospital were retrospectively reviewed. All procedures were performed without an onsite cytologist. Before the endoscopist finished the procedure, macroscopic onsite evaluation (MOSE) was confirmed. The diagnostic yield and the average number of needle passes between FNB and FNA were then compared.
RESULTS
A total of 151 patients (FNA, n = 77; FNB, n = 74) with solid pancreatic mass detected by cross-sectional imaging underwent EUS-TA. The mean age was 62.3 ± 12.8 years, with 88 (58.3%) males. Age, sex, mass location, tumour size and disease stage from imaging were not significantly different between the two groups. The diagnostic performance was higher in EUS-FNB (94.6%) than in EUS-FNA (89.6%). The mean number of needle passes was clearly fewer in FNB than in FNA (2.8 vs. 3.8, p < 0.001). The total procedure time was shorter in FNB (34.7 min) than in FNA (41 min). The adverse event rate between FNB and FNA was not significantly different.
CONCLUSIONS
The diagnostic yield of solid pancreatic mass was higher in FNB using the Franseen needle than in FNA using the conventional FNA needle in a centre where ROSE is unavailable, without serious adverse event. In addition, FNB had fewer needle passes and shorter total procedure time.
背景
内镜超声引导下组织获取（EUS-TA）是一种用于诊断实性胰腺肿块的成熟诊断程序。然而，细针抽吸（FNA）和细针活检（FNB）之间的诊断率仍不清楚。我们旨在评估和比较使用相同大小 22 号针的常规 FNA 和 Franseen 针在 EUS-TA 下进行的实性胰腺肿块患者之间的诊断率，这些患者在没有快速现场细胞学评估（ROSE）的情况下进行 EUS-TA。
方法
回顾性分析 2017 年 1 月至 2020 年 10 月期间在一家单中心大学医院接受 EUS-TA 的所有实性胰腺肿块的 FNA 或 FNB 病例。所有操作均在没有现场细胞学家的情况下进行。在内镜医生完成操作之前，进行了宏观现场评估（MOSE）。然后比较 FNB 和 FNA 之间的诊断率和平均针数。
结果
共有 151 名（FNA，n=77；FNB，n=74）接受了 EUS-TA 的实性胰腺肿块患者。平均年龄为 62.3±12.8 岁，88 名（58.3%）为男性。两组之间的年龄、性别、肿块位置、肿瘤大小和影像学疾病分期无显著差异。EUS-FNB 的诊断性能（94.6%）高于 EUS-FNA（89.6%）。FNB 的平均针数明显少于 FNA（2.8 与 3.8，p<0.001）。FNB 的总手术时间（34.7 分钟）短于 FNA（41 分钟）。FNB 和 FNA 之间的不良事件发生率无显著差异。
结论
在 ROSE 不可用的情况下，与常规 FNA 针相比，使用 Franseen 针的 FNB 对实性胰腺肿块的诊断率更高，且无严重不良事件。此外，FNB 的针数更少，总手术时间更短。
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