Takeshita Kotaro, Hijioka Susumu, Nagashio Yoshikuni, Maruki Yuta, Kawasaki Yuki, Maehara Kosuke, Murashima Yumi, Okada Mao, Ikeda Go, Yamada Natsumi, Takasaki Tetsuro, Agarie Daiki, Hara Hidenobu, Hagiwara Yuya, Okamoto Kohei, Yamashige Daiki, Ohba Akihiro, Kondo Shunsuke, Morizane Chigusa, Ueno Hideki, Saito Yutaka, Ohe Yuichiro, Okusaka Takuji
Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Cancer Medicine, Jikei University Graduate School of Medicine, Tokyo 105-0003, Japan.
Diagnostics (Basel). 2023 Jan 26;13(3):450. doi: 10.3390/diagnostics13030450.
Attempts at performing endoscopic ultrasound-guided tissue acquisition (EUS-TA) with a 19G needle are increasing because histological diagnosis and comprehensive genomic profiling are a necessity. However, the diagnostic ability of the 19G fine-needle biopsy (FNB) needle, especially the third-generation FNB needle, is unclear and has been retrospectively reviewed. The 19G TopGain needle was used in 147 patients and 160 lesions between September 2020 and December 2021. The technical success rate of the biopsies was 99.4% (159/160). The early adverse event rate was 4.1% (6/147), and moderate or severe adverse event rate occurrence was 2.0% (3/147). The sensitivity, specificity, and accuracy of the 19G TopGain needle for 157 lesions with a confirmed diagnosis were 96.7%, 100%, and 96.8%, respectively. Rescue EUS-TA using the 19G TopGain needle was performed for nine lesions, and a successful diagnosis was made in six of these lesions (66.7%). The diagnostic ability of EUS-TA using the third-generation 19G TopGain needle was favorable. However, the use of 19G FNB needles may increase adverse events. Therefore, EUS-TA with a 19G FNB needle is mainly indicated in lesions where comprehensive genomic profiling may be necessary or the diagnosis could not be determined via EUS-TA using the 22G needle.
由于组织学诊断和全面基因组分析是必要的,使用19G针进行内镜超声引导下组织获取(EUS-TA)的尝试正在增加。然而,19G细针穿刺活检(FNB)针,尤其是第三代FNB针的诊断能力尚不清楚,且已进行回顾性研究。在2020年9月至2021年12月期间,147例患者的160个病变使用了19G TopGain针。活检的技术成功率为99.4%(159/160)。早期不良事件发生率为4.1%(6/147),中度或重度不良事件发生率为2.0%(3/147)。对于157个确诊病变,19G TopGain针的敏感性、特异性和准确性分别为96.7%、100%和96.8%。对9个病变使用19G TopGain针进行挽救性EUS-TA,其中6个病变(66.7%)诊断成功。使用第三代19G TopGain针进行EUS-TA的诊断能力良好。然而,使用19G FNB针可能会增加不良事件。因此,19G FNB针EUS-TA主要适用于可能需要进行全面基因组分析或通过22G针EUS-TA无法确定诊断的病变。