Lin Yen-Chih, Yen Hsu-Heng, Huang Siou-Ping, Shih Kai-Lun, Chen Yang-Yuan
Division of Gastroenterology, Changhua Christian Hospital, Changhua 500, Taiwan.
College of Medicine, National Chung Hsing University, Taichung 400, Taiwan.
Diagnostics (Basel). 2022 Sep 1;12(9):2123. doi: 10.3390/diagnostics12092123.
The efficacy of new generation endoscopic ultrasound-guided biopsy needles has been promising in recent years. Yet, comparing these needles' diagnostic yield and safety to conventional needles is not well-known. Our study aims to compare the adverse events of endoscopic ultrasound-guided tissue acquisition (EUS-TA) with different types of needles, including FNA needles, FNB needles with a Franseen tip and FNB needles with a reverse bevel. Furthermore, we will analyze the risk factors, including tumor vascularity, different needle types, and the underlying disease, which may impact the safety of the procedures. From May 2014 to December 2021, 192 consecutive EUS-TAs were performed on pancreatic and peripancreatic lesions in our hospital using different types of FNA and FNB needles. We retrospectively reviewed the data and identified the risk factors for EUS-TA-related complications. As a result, the hypervascular tumor is a significant risk factor for adverse events in our multivariate analysis, with an odds ratio of 4.96 (95% CI 1.33-18.47), while liver cirrhosis is one of the risk factors for adverse events during EUS-TA, with an odds ratio of 5.3 (95% CI 1.1-25.6). However, the risk of adverse events did not increase using Franseen-tip needles, compared to conventional FNA or FNB needles with a reverse bevel. In conclusion, we must be more cautious in patients with liver cirrhosis and hypervascular tumors, such as pancreatic neuroendocrine tumors, when performing EUS-guided tissue acquisition.
近年来,新一代内镜超声引导下活检针的效果令人期待。然而,将这些针的诊断率和安全性与传统针进行比较的情况尚不为人所知。我们的研究旨在比较不同类型针(包括细针穿刺抽吸(FNA)针、 Franseen 尖端的细针穿刺活检(FNB)针和反向斜面的 FNB 针)在内镜超声引导下组织获取(EUS-TA)中的不良事件。此外,我们将分析可能影响操作安全性的风险因素,包括肿瘤血管情况、不同针类型以及基础疾病。2014 年 5 月至 2021 年 12 月,我们医院使用不同类型的 FNA 和 FNB 针对胰腺及胰腺周围病变连续进行了 192 例 EUS-TA。我们回顾性分析了数据并确定了 EUS-TA 相关并发症的风险因素。结果显示,在多因素分析中,高血运肿瘤是不良事件的一个重要风险因素,比值比为 4.96(95%可信区间 1.33 - 18.47),而肝硬化是 EUS-TA 期间不良事件的风险因素之一,比值比为 5.3(95%可信区间 1.1 - 25.6)。然而,与传统的反向斜面 FNA 或 FNB 针相比,使用 Franseen 尖端针时不良事件风险并未增加。总之,在对肝硬化患者以及高血运肿瘤患者(如胰腺神经内分泌肿瘤)进行 EUS 引导下组织获取时,我们必须更加谨慎。