Jaurrieta-Rico Cesar, Picazo-Ferrera Katia, Aguilar-Solis Raul, Escobedo-Paredes Daniel, Bandala-Jaques Antonio, Chavez-Gomez Viridiana, Hernandez-Guerrero Angelica, Alonso-Larraga Juan Octavio
Endoscopy Department, Instituto Nacional Cancerologia, Mexico City, Mexico.
Department of Biomedical Cancer Research, Instituto Nacional de Cancerologia, Mexico City, Mexico.
GE Port J Gastroenterol. 2022 Mar 22;30(1):49-56. doi: 10.1159/000521465. eCollection 2023 Jan.
Tissue sampling using endoscopic ultrasound-guided fine-needle aspiration is the gold standard for diagnosing malignant pancreatic tumors; however, its sensitivity and specificity are highly variable. Thus, fine-needle biopsy using cutting needles has been developed to overcome current limitations and improve diagnostic yield. Our study compared two fine-needle biopsy needles for tissue sampling for pancreatic solid lesions.
Samples obtained from patients with pancreatic solid lesions using the 22-gauge fine-needle biopsy needles (Franseen needle or reverse bevel needle) were retrospectively analyzed. The primary outcomes were diagnostic yield and sample adequacy. The secondary outcome was diagnostic performance. The analysis was performed using 2 × 2 tables to calculate sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for each needle type. Proportions were compared using the Z test. For quantitative variables, a comparative analysis was performed using Student's test. Qualitative and unpaired outcome variables were described using Fisher's exact test.
Sixty-three patients with pancreatic lesions were included in the analysis. The fine-needle biopsy Franseen and reverse bevel groups included 33 and 30 patients, respectively. An adequate sample was obtained in 97% of patients in the Franseen needle group versus 80% in the reverse bevel needle group; the diagnostic yields in these groups were 93.9 and 66.7%, respectively. Neither differences between needle passes nor complications were noted. The sensitivity and specificity were 93.5 and 100%, respectively, in the fine-needle biopsy Franseen group, versus 71 and 100%, respectively, in the reverse bevel needle group.
The Franseen needle was more effective for sampling pancreatic tumors than the reverse bevel needle.
使用超声内镜引导下细针穿刺进行组织采样是诊断胰腺恶性肿瘤的金标准；然而，其敏感性和特异性差异很大。因此，已开发出使用切割针的细针活检来克服当前的局限性并提高诊断率。我们的研究比较了两种用于胰腺实性病变组织采样的细针活检针。
回顾性分析使用22号细针活检针（弗兰森针或反斜面针）从胰腺实性病变患者中获取的样本。主要结果是诊断率和样本充足性。次要结果是诊断性能。使用2×2表格进行分析，以计算每种针型的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。使用Z检验比较比例。对于定量变量，使用学生t检验进行比较分析。定性和非配对结果变量使用费舍尔精确检验进行描述。
63例胰腺病变患者纳入分析。细针活检弗兰森组和反斜面组分别包括33例和30例患者。弗兰森针组97%的患者获得了充足的样本，而反斜面针组为80%；这些组的诊断率分别为93.9%和66.7%。未发现穿刺次数之间的差异或并发症。细针活检弗兰森组的敏感性和特异性分别为93.5%和100%，而反斜面针组分别为71%和100%。
弗兰森针在胰腺肿瘤采样方面比反斜面针更有效。
