The diagnostic yield of specimens obtained from endoscopic ultrasound guided fine needle biopsy of solid masses with the AcquireTM needle
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Background: Recent developments in the design of needle tips used for fine needle biopsy via endoscopic ultrasound (EUS) allows for the procurement of core tissue for histological assessment in addition to cytology. Core tissue provides tissue architecture as well as the ability to perform molecular profiling investigations. We present a single centre study of experience with a new EUS needle with a Franseen tip (AcquireTM; Boston Scientific, Natick, MA, USA). The aim of the study was to assess the diagnostic yield of biopsies from solid lesions throughout the gastrointestinal tract. Methods: We performed a retrospective study of consecutive patients undergoing EUS biopsy between January 2017 and November 2018. Cystic lesions with no solid component were excluded or if samples were not sent for both cytology and histology. Rapid onsite evaluation (ROSE) was performed and the core tissue obtained was sent for histology. Results: Forty-six patients underwent EUS biopsy of solid lesions with specimens sent for both cytology and histology. Lesions included solid pancreatic masses (n = 31), lymph node (n = 3), gastric subepithelial lesion (n = 3), other (n = 9). The mean number of passes per lesion was 1.9 (range 1–4). In 43/46 (93%) of cases, a core specimen was obtained. Tissue obtained by EUS biopsy was adequate for evaluation by ROSE in 39/46 cases (85%). Histological diagnosis was confirmed in 41/46 (89%) cases compared to 31/46 (67%) cases with cytology (P = 0.011). Subgroup analysis of pancreatic lesions showed histological diagnosis was superior to cytology (90% vs 61%, P = 0.007). There were no adverse events. Conclusion: Histological analysis of specimens obtained via EUS biopsy was superior to cytology, particularly in assessment of solid pancreatic lesions.
Abstract
Background: Recent developments in the design of needle tips used for fine needle biopsy via endoscopic ultrasound (EUS) allows for the procurement of core tissue for histological assessment in addition to cytology. Core tissue provides tissue architecture as well as the ability to perform molecular profiling investigations. We present a single centre study of experience with a new EUS needle with a Franseen tip (AcquireTM; Boston Scientific, Natick, MA, USA). The aim of the study was to assess the diagnostic yield of biopsies from solid lesions throughout the gastrointestinal tract. Methods: We performed a retrospective study of consecutive patients undergoing EUS biopsy between January 2017 and November 2018. Cystic lesions with no solid component were excluded or if samples were not sent for both cytology and histology. Rapid onsite evaluation (ROSE) was performed and the core tissue obtained was sent for histology. Results: Forty-six patients underwent EUS biopsy of solid lesions with specimens sent for both cytology and histology. Lesions included solid pancreatic masses (n = 31), lymph node (n = 3), gastric subepithelial lesion (n = 3), other (n = 9). The mean number of passes per lesion was 1.9 (range 1–4). In 43/46 (93%) of cases, a core specimen was obtained. Tissue obtained by EUS biopsy was adequate for evaluation by ROSE in 39/46 cases (85%). Histological diagnosis was confirmed in 41/46 (89%) cases compared to 31/46 (67%) cases with cytology (P = 0.011). Subgroup analysis of pancreatic lesions showed histological diagnosis was superior to cytology (90% vs 61%, P = 0.007). There were no adverse events. Conclusion: Histological analysis of specimens obtained via EUS biopsy was superior to cytology, particularly in assessment of solid pancreatic lesions.
참고문헌 (20)
- Kim EJ, "Pilot clinical trial of hedgehog pathway inhibitor GDC-0449(vismodegib)in combination with gemcitabine in patients with metastatic pancreatic adenocarcinoma", Clin Cancer Res, 20, pp.5937~5945 (2014)
- Varadarajulu S, "The changing paradigm in EUS-guided tissue acquisition", Gastrointest Endosc Clin N Am, 24, pp.1~7 (2014)
- Kaffes AJ, "A prospective multicenter evaluation of a new side-port endoscopic ultrasound-fine-needle aspiration in solid upper gastrointestinal lesions", Dig Endosc, 24, pp.448~451 (2012)
- Fuccio L, "Endoscopic ultrasound-guided fine needle aspiration: How to obtain a core biopsy?", Endosc Ultrasound, 3, pp.71~81 (2014)
- Al-Haddad M, "Su1320 prospective assessment of the performance of a new fine needle biopsy device at 2 large referral centers", Gastrointest Endosc, 85(Suppl), pp.AB333~ (2017)
- Bang JY, "Endoscopic ultrasonography-guided biopsy using a Franseen needle design : initial assessment", Dig Endosc, 29, pp.338~346 (2017)
- Iglesias-Garcia J, "Feasibility and yield of a new EUS histology needle : results from a multicenter, pooled, cohort study", Gastrointest Endosc, 73, pp.1189~1196 (2011)
- Jenssen C, "Endoscopic ultrasound-guided fine-needle aspiration biopsy and trucut biopsy in gastroenterology-an overview", Best Pract Res Clin Gastroenterol, 23, pp.743~759 (2009)
- Saxena P, "Stylet slow-pull versus standard suction for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic lesions : a multicenter randomized trial", Endoscopy, 50, pp.497~504 (2018)
- Siegel R, "Cancer statistics, 2012", CA Cancer J Clin, 62, pp.10~29 (2012)
- Simard EP, "Cancers with increasing incidence trends in the United States : 1999 through 2008", CA Cancer J Clin, 62, pp.118~128 (2012)
- Wani S, "The clinical impact of immediate on-site cytopathology evaluation during endoscopic ultrasound-guided fine needle aspiration of pancreatic masses : a prospective multicenter randomized controlled trial", Am J Gastroenterol, 110, pp.1429~1439 (2015)
- Mitri DR, "Su1364high yield of core tissue for histological analysis with high diagnostic accuracy of EUS-fine needle biopsy using the 22G acquire needle: a multicenter prospective study", Gastrointest Endosc, 85(Suppl), pp.AB351~ (2017)
- Adler DG, "Pathologic evaluation of a new endoscopic ultrasound needle designed to obtain core tissue samples : a pilot study", Endosc Ultrasound, 5, pp.178~183 (2016)
- DiMaio CJ, "Initial experience with a novel EUS-guided core biopsy needle(SharkCore) : results of a large North American multicenter study", Endosc Int Open, 4, pp.E974~9 (2016)
- Adler DG, "A multicenter evaluation of a new EUS core biopsy needle : experience in 200 patients", Endosc Ultrasound, 8, pp.99~104 (2019)
- Adler DG, "Su1319 clinical and pathologic evaluation of a new EUS core biopsy needle: a large multicenter trial", Gastrointest Endosc, 85(Suppl), pp.AB333~ (2017)
- Attili F, "Performance of a new histology needle for EUS-guided fine needle biopsy : a retrospective multicenter study", Dig Liver Dis, 50, pp.469~474 (2018)
- Tian L, "Evaluation of 22G fineneedle aspiration(FNA)versus fine-needle biopsy(FNB)for endoscopic ultrasound-guided sampling of pancreatic lesions : a prospective comparison study", Surg Endosc, 32, pp.3533~3539 (2018)
- Hébert-Magee S, "The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma : a meta-analysis", Cytopathology, 24, pp.159~171 (2013)