Aboudara Matthew C, Saettele Timothy, Tawfik Ossama
Division of Pulmonary and Critical Care, Saint Luke's Health System, Frank and Evangeline Thompson Thoracic Center, Kansas City, MO, USA.
Division of Pulmonary and Critical Care, Saint Luke's Health System, Frank and Evangeline Thompson Thoracic Center, Kansas City, MO, USA.
Respir Med. 2023 Mar;208:107131. doi: 10.1016/j.rmed.2023.107131. Epub 2023 Jan 30.
The Franseen fine needle biopsy tool (Acquire®, Boston Scientific, Boston, MA) may provide better quality specimens than current endobronchial ultrasound-transbronchial needle aspiration (EBUS-TNBA) needles. We performed a comparative retrospective study evaluating the diagnostic yield of the Franseen fine needle biopsy (FNB) versus standard fine needle aspiration (FNA) for benign lymphadenopathy and tissue acquisition for next generation sequencing (NGS) in non-small cell carcinoma (NSCLC).
All EBUS-TBNA procedures performed between January 1st, 2019 to January 1st 2020 where both the FNB needle and the FNA needle were used were analyzed. All demographic, procedural, and diagnostic data were recorded. The median tumor surface area, tumor cellularity and adequacy for NGS was evaluated for NSCLC specimens.
A total of 69 target lesions in 66 patients were biopsied with both the FNB and FNA needles. The mean (SD) size of target biopsied was 1.8 cm (0.8); The most common stations were 7 (54%) and 4R (26%). The mean (SD) needle passes were 6 (2.2) and 4 (1.8) with FNA and FNB needles, respectively (p < 0.0001). Benign lymphadenopathy was diagnosed with FNA needle in 46% and in 82% with FNB (p < 0.0001). NGS tissue adequacy was 47% with FNA needle versus 76% with FNB (p = 0.02). Median tumor surface area and tumor cellularity were greater with FNB needle than FNA needle (80 mm versus 9 mm, p = 0.002, and 81% versus 45%, p = 0.0004).
The FNB needle demonstrated higher diagnostic yield in benign lymphadenopathy and higher quality for NGS than standard FNA needle.
弗兰森细针活检工具（Acquire®，波士顿科学公司，马萨诸塞州波士顿）可能比当前的支气管内超声引导经支气管针吸活检（EBUS-TNBA）针提供质量更好的标本。我们进行了一项比较性回顾性研究，评估弗兰森细针活检（FNB）与标准细针穿刺抽吸（FNA）对良性淋巴结病的诊断率以及在非小细胞肺癌（NSCLC）中获取用于下一代测序（NGS）的组织的情况。
分析了2019年1月1日至2020年1月1日期间所有同时使用FNB针和FNA针的EBUS-TBNA操作。记录所有人口统计学、操作和诊断数据。对NSCLC标本评估肿瘤表面积中位数、肿瘤细胞密度以及用于NGS的充足性。
66例患者中的69个目标病变同时用FNB针和FNA针进行了活检。活检目标的平均（标准差）大小为1.8 cm（0.8）；最常见的部位是7区（54%）和4R区（26%）。FNA针和FNB针的平均（标准差）穿刺次数分别为6次（2.2）和4次（1.8）（p < 0.0001）。FNA针诊断出良性淋巴结病的比例为46%，FNB针为82%（p < 0.0001）。FNA针获取的用于NGS的组织充足率为47%，FNB针为76%（p = 0.02）。FNB针的肿瘤表面积中位数和肿瘤细胞密度大于FNA针（80 mm对9 mm，p = 0.002；81%对45%，p = 0.0004）。
与标准FNA针相比，FNB针在良性淋巴结病中显示出更高的诊断率，并且在用于NGS时质量更高。
