Mohamed Wael T, Jahagirdar Vinay, Jaber Fouad, Ahmed Mohamed K, Fatima Ifrah, Bierman Thomas, Fu Zhuxuan, Jones Philip G, Hassan Amira F, Faber Erin, Clarkston Wendell K, Ghoz Hassan, Tawfik Ossama W, Jonnalagadda Sreeni
Department of Transplant Hepatology, Cleveland Clinic, Cleveland, OH 44114, USA.
Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA.
Cancers (Basel). 2024 Feb 12;16(4):761. doi: 10.3390/cancers16040761.
There is limited literature on sample adequacy for molecular testing in pancreatic ductal adenocarcinoma obtained via endoscopic ultrasound (EUS) fine-needle aspiration (FNA) versus EUS fine-needle biopsy (FNB). We aimed to compare these two modalities regarding sample adequacy for molecular and genomic sequencing.
We reviewed all patients with pancreatic ductal adenocarcinoma who underwent EUS at Saint Luke's Hospital from 2018 to 2021. The patients were categorized based on the method of EUS tissue acquisition, specifically FNA or FNB. A comprehensive evaluation was conducted for all cases by cytotechnologists.
Out of 132 patients who underwent EUS-guided biopsies, 76 opted for FNA, 48 opted for FNB, and 8 opted for a combination of both. The average number of passes required for FNB and FNA was 2.58 ± 1.06 and 2.49 ± 1.07, respectively ( = 0.704), indicating no significant difference. Interestingly, 71.4% (35) of FNB-obtained samples were deemed adequate for molecular testing, surpassing the 32.1% (26) adequacy observed with FNA ( < 0.001). Additionally, 46.4% (26) of FNB-obtained samples were considered adequate for genomic testing, a notable improvement over the 23.8% (20) adequacy observed with FNA ( = 0.005).
Although the number of passes required for cytologic diagnosis did not differ significantly between EUS-FNB and EUS-FNA, the former demonstrated superiority in obtaining samples adequate for molecular testing. Tumor surface area and cellularity were crucial parameters in determining sample adequacy for molecular testing, irrespective of the chosen tissue acquisition modality.
关于通过内镜超声（EUS）细针穿刺抽吸（FNA）与EUS细针活检（FNB）获取的胰腺导管腺癌分子检测样本充足性的文献有限。我们旨在比较这两种方法在分子和基因组测序样本充足性方面的差异。
我们回顾了2018年至2021年在圣卢克医院接受EUS检查的所有胰腺导管腺癌患者。根据EUS组织获取方法，将患者分为FNA组或FNB组。细胞技术人员对所有病例进行了全面评估。
在132例接受EUS引导活检的患者中，76例选择FNA，48例选择FNB，8例选择两者结合。FNB和FNA所需的平均穿刺次数分别为2.58±1.06和2.49±1.07（P=0.704），表明无显著差异。有趣的是，71.4%（35）的FNB获取样本被认为适合分子检测，超过了FNA的32.1%（26）（P<0.001）。此外，46.4%（26）的FNB获取样本被认为适合基因组检测，显著优于FNA的23.8%（20）（P=0.005）。
尽管EUS-FNB和EUS-FNA在细胞学诊断所需的穿刺次数上无显著差异，但前者在获取适合分子检测的样本方面表现出优势。无论选择何种组织获取方式，肿瘤表面积和细胞密度都是决定分子检测样本充足性的关键参数。
