Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, 65 Tsurumai-Cho, Showa-Ku, Nagoya, 466-8560, Japan.
Department of Endoscopy, Nagoya University Hospital, Nagoya, Japan.
J Med Ultrason (2001). 2024 Apr;51(2):209-217. doi: 10.1007/s10396-023-01375-y. Epub 2023 Nov 1.
This article provides an extensive review of the advancements and future perspectives related to endoscopic ultrasound-guided tissue acquisition (EUS-TA) for the diagnosis of solid pancreatic lesions (SPLs). EUS-TA, including fine-needle aspiration (EUS-FNA) and fine-needle biopsy (EUS-FNB), has revolutionized the collection of specimens from intra-abdominal organs, including the pancreas. Improvements in the design of needles, collection methods, and specimen processing techniques have improved the diagnostic performance. This review highlights the latest findings regarding needle evolution, actuation number, sampling methods, specimen evaluation techniques, application of artificial intelligence (AI) for diagnostic purposes, and use of comprehensive genomic profiling (CGP). It acknowledges the rising use of Franseen and fork-tip needles for EUS-FNB and emphasizes that the optimal number of actuations requires further study. Methods such as the door-knocking and fanning techniques have shown promise for increasing diagnostic performance. Macroscopic on-site evaluation (MOSE) is presented as a practical rapid specimen evaluation method, and the integration of AI is identified as a potentially impactful development. The study also underscores the importance of optimal sampling for CGP, which can enhance the precision of cancer treatment. Ongoing research and technological innovations will further improve the accuracy and efficacy of EUS-TA.
本文对内镜超声引导下组织采集（EUS-TA）在诊断胰腺实性病变（SPL）方面的进展和未来展望进行了全面回顾。EUS-TA 包括细针抽吸（EUS-FNA）和细针活检（EUS-FNB），它彻底改变了包括胰腺在内的腹腔内器官标本的采集方式。针的设计、采集方法和标本处理技术的改进提高了诊断性能。本文重点介绍了关于针的演变、激发次数、采样方法、标本评估技术、人工智能（AI）在诊断中的应用以及综合基因组分析（CGP）的最新发现。文中还提到了 Frasen 针和叉状针在 EUS-FNB 中的应用越来越多，并强调需要进一步研究最佳激发次数。敲门和扇动技术等方法显示出提高诊断性能的潜力。宏观现场评估（MOSE）被提出作为一种实用的快速标本评估方法，集成 AI 被认为是一个具有潜在影响力的发展方向。该研究还强调了为 CGP 进行最佳采样的重要性，这可以提高癌症治疗的精准度。目前正在进行的研究和技术创新将进一步提高 EUS-TA 的准确性和效果。
