Predictive factors for the diagnosis of autoimmune pancreatitis using endoscopic ultrasound-guided tissue acquisition: a retrospective study in Japan
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Background/Aims: The factors affecting the detection rate of lymphoplasmacytic sclerosing pancreatitis (LPSP) using endoscopic ultrasound-guided tissue acquisition (EUS-TA) in patients with type 1 autoimmune pancreatitis (AIP) have not been thoroughly studied. Therefore, we conducted a retrospective study to identify the predictive factors for histologically detecting level 1 or 2 LPSP using EUSTA. Methods: Fifty patients with AIP were included in this study, and the primary outcome measures were the predictive factors for histologicallydetecting level 1 or 2 LPSP using EUS-TA. Results: Multivariate analysis identified the use of fine needle biopsy (FNB) needles as a significant predictive factor for LPSP detection(odds ratio, 15.1; 95% confidence interval, 1.62–141; p=0.02). The rate of good-quality specimens (specimen adequacy score ≥4) wassignificantly higher for the FNB needle group than for the fine needle aspiration (FNA) needle group (97% vs. 56%; p<0.01), and theFNB needle group required significantly fewer needle passes than the FNA needle group (median, 2 vs. 3; p<0.01). Conclusions: The use of FNB needles was the most important factor for the histological confirmation of LPSP using EUS-TA in patientswith type 1 AIP.
Abstract
Background/Aims: The factors affecting the detection rate of lymphoplasmacytic sclerosing pancreatitis (LPSP) using endoscopic ultrasound-guided tissue acquisition (EUS-TA) in patients with type 1 autoimmune pancreatitis (AIP) have not been thoroughly studied. Therefore, we conducted a retrospective study to identify the predictive factors for histologically detecting level 1 or 2 LPSP using EUSTA. Methods: Fifty patients with AIP were included in this study, and the primary outcome measures were the predictive factors for histologicallydetecting level 1 or 2 LPSP using EUS-TA. Results: Multivariate analysis identified the use of fine needle biopsy (FNB) needles as a significant predictive factor for LPSP detection(odds ratio, 15.1; 95% confidence interval, 1.62–141; p=0.02). The rate of good-quality specimens (specimen adequacy score ≥4) wassignificantly higher for the FNB needle group than for the fine needle aspiration (FNA) needle group (97% vs. 56%; p<0.01), and theFNB needle group required significantly fewer needle passes than the FNA needle group (median, 2 vs. 3; p<0.01). Conclusions: The use of FNB needles was the most important factor for the histological confirmation of LPSP using EUS-TA in patientswith type 1 AIP.