Ahmed Marwa A, Ahmed Mohamed Yousri, Shaaban Hossam Eldin, Abou Elenin Sameh E A, El-Habashi Ahmed Ali, Belabbes Fatima, Tag-Adeen Mohammed, Abdellatef Abeer, Okasha Hussein Hassan
National Cancer Institute (NCI), Cairo University, Cairo, Egypt.
Department of Internal Medicine and Gastroenterology, National Hepatology and Tropical Medicine Research Institute, Cairo, 11796, Egypt.
Int J Gen Med. 2025 Jun 4;18:2851-2860. doi: 10.2147/IJGM.S516107. eCollection 2025.
Endoscopic ultrasound (EUS)-guided tissue acquisition is the procedure of choice to obtain samples to diagnose pancreatic and non-pancreatic lesions. Previous randomized trials demonstrated that using stylets during the EUS-fine needle biopsy (FNB) technique does not improve the diagnostic yield. However, little data exists regarding the role of stylet and suction in the core biopsy needle during EUS-guided tissue acquisition.
This study aims to assess the efficacy and diagnostic yield of samples collected by EUS-FNB with stylet and suction versus no stylet, no suction techniques.
This prospective study included 167 patients referred to the Gastroenterology Division, Internal Medicine Department, Kasr Al-Aini Hospitals for EUS-guided biopsy from pancreatic or non-pancreatic lesions from May 2021 to January 2024. Each lesion was sampled twice using an EUS-FNB 22-gauge Franseen-tip needle (Acquire; Boston Scientific, USA); one sample was collected with stylet and suction, while the other with no stylet no suction technique. Subsequently, slides were evaluated for cellularity, tissue integrity, degree of blood contamination, and diagnostic ability.
A total of 167 patients fulfilled the inclusion criteria, 78 females and 89 males, with a mean age of 61 years. Most lesions were pancreatic (83.2%, n = 139), while the remaining (16.8%, n = 28) were non-pancreatic. No significant differences were observed between stylet and suction versus no stylet, no suction techniques. The diagnostic performance, including sensitivity, specificity, and overall accuracy, was identical (100%) for both methods when evaluating alcohol-fixed smears in conjunction with formalin-preserved tissues collected through FNB.
EUS-FNB tissue acquisition with and without stylet and suction provides comparable diagnostic yield and tissue quality for pancreatic and non-pancreatic lesions. The decision to use a stylet and suction should be individualized based on the clinical context and operator experience.
内镜超声（EUS）引导下的组织获取是获取样本以诊断胰腺和非胰腺病变的首选方法。先前的随机试验表明，在EUS细针穿刺活检（FNB）技术中使用针芯并不能提高诊断率。然而，关于在EUS引导下的组织获取过程中针芯和抽吸在粗针活检针中的作用的数据很少。
本研究旨在评估使用带针芯和抽吸与不使用针芯、不抽吸技术的EUS-FNB所采集样本的有效性和诊断率。
这项前瞻性研究纳入了2021年5月至2024年1月期间转诊至开罗大学医学院艾因医院内科胃肠病科进行EUS引导下胰腺或非胰腺病变活检的167例患者。每个病变使用EUS-FNB 22G Franseen头针（Acquire；美国波士顿科学公司）取样两次；一个样本采用带针芯和抽吸的方式采集，另一个采用不使用针芯、不抽吸技术采集。随后，对玻片进行细胞数量、组织完整性、血液污染程度和诊断能力的评估。
共有167例患者符合纳入标准，其中女性78例，男性89例，平均年龄61岁。大多数病变为胰腺病变（83.2%[n = 139]），其余为非胰腺病变（16.8%[n = 28]）。带针芯和抽吸与不使用针芯、不抽吸技术之间未观察到显著差异。在评估酒精固定涂片以及通过FNB采集的福尔马林固定组织时，两种方法的诊断性能（包括敏感性、特异性和总体准确性）相同（均为100%）。
使用和不使用针芯及抽吸的EUS-FNB组织获取方法在胰腺和非胰腺病变中提供了相当的诊断率和组织质量。是否使用针芯和抽吸应根据临床情况和操作者经验进行个体化决策。
