Kurita Yusuke, Kubota Kensuke, Harada Jotaro, Honda Yu, Yamazaki Yuma, Iizuka Takeshi, Nihei Shinichi, Hasegawa Sho, Hosono Kunihiro, Kobayashi Noritoshi, Fujii Satoshi, Endo Itaru, Nakajima Atsushi
Department of Gastroenterology and Hepatology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
Department of Molecular Pathology, Yokohama City University Hospital, Yokohama, Kanagawa, Japan.
J Hepatobiliary Pancreat Sci. 2025 Mar;32(3):238-245. doi: 10.1002/jhbp.12095. Epub 2024 Dec 6.
The choice between 22-gauge endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) and EUS-guided fine-needle aspiration (EUS-FNA) for histological diagnosis of type 1 autoimmune pancreatitis (AIP) is unclear. We retrospectively examined the detection rate of histological findings for AIP using EUS-FNA/FNB.
Patients diagnosed with type 1 AIP using EUS-FNB (Franseen needle) or EUS-FNA (conventional needle) with 22-gauge needles at our hospital between 2012 and 2023 were included in this study. AIP was diagnosed according to International Consensus Diagnostic Criteria (ICDC). The detection rates of level 1 findings, which included storiform fibrosis and/or obliterative phlebitis, and level 2 histological findings were evaluated according to the ICDC.
The EUS-FNB and EUS-FNA groups included 25 and 24 patients, respectively. No significant differences in patient background were noted between the two groups. The detection rates of prominent filtration of lymphocytes and plasma cells along with fibrosis were 56.0% in the EUS-FNB group and 12.5% in the EUS-FNA group (p = .001). The detection rates of more than 10 IgG4-positive plasma cells per high-power microscopic field were 68.0% and 29.2% in the EUS-FNB and EUS-FNA groups, respectively (p = .007). The histological findings for levels 1 and 2 were significantly higher in the EUS-FNB group (56.0% vs. 12.5%; p = .001). Mild pancreatitis was observed in the EUS-FNB group; however, no other serious adverse events occurred.
The 22-gauge EUS-FNB yielded a higher rate of histological findings than 22-gauge EUS-FNA, suggesting that 22-gauge EUS-FNB is suitable and safe for the histological diagnosis of type 1 AIP.
对于1型自身免疫性胰腺炎（AIP）的组织学诊断，22G内镜超声引导下细针穿刺活检（EUS-FNB）与内镜超声引导下细针抽吸术（EUS-FNA）之间的选择尚不清楚。我们回顾性研究了使用EUS-FNA/FNB对AIP组织学表现的检出率。
本研究纳入了2012年至2023年期间在我院使用22G针进行EUS-FNB（ Franseen针）或EUS-FNA（传统针）诊断为1型AIP的患者。AIP根据国际共识诊断标准（ICDC）进行诊断。根据ICDC评估1级表现（包括席纹状纤维化和/或闭塞性静脉炎）和2级组织学表现的检出率。
EUS-FNB组和EUS-FNA组分别有25例和24例患者。两组患者的背景无显著差异。EUS-FNB组淋巴细胞和浆细胞显著浸润伴纤维化的检出率为56.0%，EUS-FNA组为12.5%（p = 0.001）。EUS-FNB组和EUS-FNA组每高倍镜视野中超过10个IgG4阳性浆细胞的检出率分别为68.0%和29.2%（p = 0.007）。EUS-FNB组1级和2级组织学表现显著更高（56.0%对12.5%；p = 0.001）。EUS-FNB组观察到轻度胰腺炎；然而，未发生其他严重不良事件。
22G EUS-FNB比22G EUS-FNA产生更高的组织学表现检出率，表明22G EUS-FNB适用于1型AIP的组织学诊断且安全。
