Comparison of Histologic Core Portions Acquired from a Core Biopsy Needle and a Conventional Needle in Solid Mass Lesions: A Prospective Randomized Trial
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Background/Aims: The superiority of endoscopic ultrasound- guided fine needle biopsy (EUS-FNB) over EUS-guided fine needle aspiration (EUS-FNA) remains controversial. Given the lack of studies analyzing histologic specimens acquired from EUS-FNB or EUS-FNA, we compared the proportion of the histologic core obtained from both techniques. Methods: A total of 58 consecutive patients with solid mass lesions were enrolled and randomly assigned to the EUSFNA or EUS-FNB groups. The opposite needle was used after the failure of core tissue acquisition using the initial needle with up to three passes. Using computerized analyses of the scanned histologic slide, the overall area and the area of the histologic core portion in specimens obtained by the two techniques were compared. Results: No significant differences were identified between the two groups with respect to demographic and clinical characteristics. Fewer needle passes were required to obtain core specimens in the FNB group (p<0.001). There were no differences in the proportion of histologic core (11.8%±19.5% vs 8.0%±11.1%, p=0.376) or in the diagnostic accuracy (80.6% vs 81.5%, p=0.935) between two groups. Conclusions: The proportion of histologic core and the diagnostic accuracy were comparable between the FNB and FNA groups. However, fewer needle passes were required to establish an accurate diagnosis in EUS-FNB.
Abstract
Background/Aims: The superiority of endoscopic ultrasound- guided fine needle biopsy (EUS-FNB) over EUS-guided fine needle aspiration (EUS-FNA) remains controversial. Given the lack of studies analyzing histologic specimens acquired from EUS-FNB or EUS-FNA, we compared the proportion of the histologic core obtained from both techniques. Methods: A total of 58 consecutive patients with solid mass lesions were enrolled and randomly assigned to the EUSFNA or EUS-FNB groups. The opposite needle was used after the failure of core tissue acquisition using the initial needle with up to three passes. Using computerized analyses of the scanned histologic slide, the overall area and the area of the histologic core portion in specimens obtained by the two techniques were compared. Results: No significant differences were identified between the two groups with respect to demographic and clinical characteristics. Fewer needle passes were required to obtain core specimens in the FNB group (p<0.001). There were no differences in the proportion of histologic core (11.8%±19.5% vs 8.0%±11.1%, p=0.376) or in the diagnostic accuracy (80.6% vs 81.5%, p=0.935) between two groups. Conclusions: The proportion of histologic core and the diagnostic accuracy were comparable between the FNB and FNA groups. However, fewer needle passes were required to establish an accurate diagnosis in EUS-FNB.
참고문헌 (24)
- Chang KJ, "Endoscopic ultrasound-guided fine needle aspiration of pancreatic carcinoma", Am J Gastroenterol, 89, pp.263~266 (1994)
- Vilmann P, "Endosonographically- guided fine needle aspiration biopsy of malignant lesions in the upper gastrointestinal tract", Endoscopy, 25, pp.523~527 (1993)
- Wiersema MJ, "Mediastinal histoplasmosis: evaluation with endosonography and endoscopic fine-needle aspiration biopsy", Gastrointest Endosc, 40, pp.78~81 (1994)
- Hewitt MJ, "EUS-guided FNA for diagnosis of solid pancreatic neoplasms: a meta-analysis", Gastrointest Endosc, 75, pp.319~331 (2012)
- Chen G, "Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration for pancreatic cancer: a meta-analysis", Pancreatology, 13, pp.298~304 (2013)
- Itoi T, "Current status of diagnostic endoscopic ultrasonography in the evaluation of pancreatic mass lesions", Dig Endosc, 23(Suppl 1), pp.17~21 (2011)
- Wiersema MJ, "Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment", Gastroenterology, 112, pp.1087~1095 (1997)
- Ribeiro A, "EUS-guided fine-needle aspiration combined with flow cytometry and immunocytochemistry in the diagnosis of lymphoma", Gastrointest Endosc, 53, pp.485~491 (2001)
- Mesa H, "Diagnosis of nonprimary pancreatic neoplasms by endoscopic ultrasound-guided fine-needle aspiration", Diagn Cytopathol, 31, pp.313~318 (2004)
- Levy MJ, "Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA", Gastrointest Endosc, 57, pp.101~106 (2003)
- Bang JY, "Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions", Gastrointest Endosc, 76, pp.321~327 (2012)
- 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)
- Lee YN, "Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study", Endoscopy, 46, pp.1056~1062 (2014)
- Nakai Y, "Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses", Dig Dis Sci, 59, pp.1578~1585 (2014)
- Wahnschaffe U, "EUS-guided Trucut needle biopsies as first-line diagnostic method for patients with intestinal or extraintestinal mass lesions", Surg Endosc, 23, pp.2351~2355 (2009)
- Erickson RA, "Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies", Gastrointest Endosc, 51, pp.184~190 (2000)
- Levy MJ, "EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice", Gastrointest Endosc, 61, pp.467~472 (2005)
- Afify AM, "Endoscopic ultrasound- guided fine needle aspiration of the pancreas: diagnostic utility and accuracy", Acta Cytol, 47, pp.341~348 (2003)
- Iglesias-Garcia J, "Influence of on-site cytopathology evaluation on the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solid pancreatic masses", Am J Gastroenterol, 106, pp.1705~1710 (2011)
- Turner BG, "Diagnosis of pancreatic neoplasia with EUS and FNA: a report of accuracy", Gastrointest Endosc, 71, pp.91~98 (2010)
- Song TJ, "The prospective randomized, controlled trial of endoscopic ultrasound-guided fine-needle aspiration using 22G and 19G aspiration needles for solid pancreatic or peripancreatic masses", Am J Gastroenterol, 105, pp.1739~1745 (2010)
- Hucl T, "Feasibility and efficiency of a new 22G core needle: a prospective comparison study", Endoscopy, 45, pp.792~798 (2013)
- Iwashita T, "High single-pass diagnostic yield of a new 25-gauge core biopsy needle for EUSguided FNA biopsy in solid pancreatic lesions", Gastrointest Endosc, 77, pp.909~915 (2013)
- Noh KW, "Changing trends in endosonography: linear imaging and tissue are increasingly the issue", Dig Dis Sci, 52, pp.1014~1018 (2007)