Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
J Gastroenterol. 2022 Dec;57(12):990-998. doi: 10.1007/s00535-022-01926-z. Epub 2022 Oct 3.
There are limited studies on the results of comprehensive genomic profiling testing for pancreatic cancer tissue specimens by endoscopic ultrasound-guided tissue acquisition (EUS-TA). This study aimed to evaluate the proportion of specimens obtained by EUS-TA using a 19-gauge (G) fine-needle biopsy (FNB) needle for unresectable pancreatic cancer (UR-PC) that met the OncoGuide NCC Oncopanel System (NOP) analysis suitability criteria.
In this single-arm, prospective, phase II study, EUS-TA was performed using a 19G FNB biopsy needle in patients with suspected UR-PC based on a contrast-enhanced computed tomography scan. The primary endpoint was the proportion of patients who met the NOP analysis suitability criteria, with a threshold, expected value, α-error, and power of 40%, 70%, 0.025, and 0.9, respectively, and the planned number of enrolled patients was 33. The NOP analysis suitability criteria were defined as tumor cell content ≥ 20% and tissue size ≥ 4 mm.
Thirty-three patients were enrolled. The procedural success rate was 100%, and the cytodiagnosis of class V was observed in all patients. The proportion of patients meeting the NOP analysis suitability criteria was 63.6% (95% CI 47.22-80.05), which satisfied the predefined criteria to be considered valid. Adverse events occurred in 9.0% of the patients.
The proportion of patients with UR-PC who met the NOP analysis suitability criteria for EUS-TA using a 19G FNB needle was effective for achieving the primary endpoint, making it a valid test method. Adverse events occurred at a higher rate than that previously reported.
内镜超声引导下组织获取(EUS-TA)用于胰腺癌症组织标本的综合基因组分析检测结果的研究有限。本研究旨在评估 EUS-TA 中使用 19G 细针活检(FNB)针获取不可切除性胰腺癌(UR-PC)标本的比例,以满足 OncoGuide NCC Oncopanel 系统(NOP)分析适用性标准。
在这项单臂、前瞻性、二期研究中,根据增强 CT 扫描怀疑 UR-PC 的患者进行 EUS-TA,使用 19G FNB 活检针。主要终点是符合 NOP 分析适用性标准的患者比例,阈值、预期值、α误差和功效分别为 40%、70%、0.025 和 0.9,计划入组患者数为 33 例。NOP 分析适用性标准定义为肿瘤细胞含量≥20%且组织大小≥4mm。
共入组 33 例患者。操作成功率为 100%,所有患者均观察到细胞学诊断为 V 级。符合 NOP 分析适用性标准的患者比例为 63.6%(95%CI:47.22-80.05),满足预设标准,可认为有效。9.0%的患者发生不良事件。
使用 19G FNB 针进行 EUS-TA 的 UR-PC 患者中符合 NOP 分析适用性标准的比例,达到了主要终点,是一种有效的测试方法。不良事件发生率高于既往报道。