Modified Endoscopic Ultrasound Needle to Obtain Histological Core Tissue Samples: A Retrospective Analysis
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration is very effective for providing specimens forcytological evaluation. However, the ability to provide sufficient tissue for histological evaluation has been challenging due to thetechnical limitations of dedicated core biopsy needles. Recently, a modified EUS needle has been introduced to obtain tissue coresamples for histological analysis. We aimed to determine (1) its ability to obtain specimens for histological assessment and (2) thediagnostic accuracy of EUS-guided fine-needle biopsy (EUS-FNB) using this needle. Methods: We retrospectively analyzed consecutive cases of FNB using modified EUS needles for 342 lesions in 303 patients. Thecytology and histological specimens were analyzed. Diagnostic accuracy was calculated. Results: Adequate cytological and histological assessment was possible in 293/342 (86%) and 264/342 (77%) lesions, respectively. Diagnostic accuracy of the cytological specimen was 294/342 (86%) versus 254/342 (74%) for the histological specimen (p<0.01). Diagnostic accuracy of the combined cytological and histological assessment was 323/342 (94.4%), which was significantly higher thanthat of both histology alone (p<0.001) and cytology alone (p=0.001). Conclusions: EUS-FNB with the modified EUS needle provided histologic tissue cores in the majority of cases and achieved excellentdiagnostic accuracy with few needle passes.
Abstract
Background/Aims: Endoscopic ultrasound (EUS)-guided fine-needle aspiration is very effective for providing specimens forcytological evaluation. However, the ability to provide sufficient tissue for histological evaluation has been challenging due to thetechnical limitations of dedicated core biopsy needles. Recently, a modified EUS needle has been introduced to obtain tissue coresamples for histological analysis. We aimed to determine (1) its ability to obtain specimens for histological assessment and (2) thediagnostic accuracy of EUS-guided fine-needle biopsy (EUS-FNB) using this needle. Methods: We retrospectively analyzed consecutive cases of FNB using modified EUS needles for 342 lesions in 303 patients. Thecytology and histological specimens were analyzed. Diagnostic accuracy was calculated. Results: Adequate cytological and histological assessment was possible in 293/342 (86%) and 264/342 (77%) lesions, respectively. Diagnostic accuracy of the cytological specimen was 294/342 (86%) versus 254/342 (74%) for the histological specimen (p<0.01). Diagnostic accuracy of the combined cytological and histological assessment was 323/342 (94.4%), which was significantly higher thanthat of both histology alone (p<0.001) and cytology alone (p=0.001). Conclusions: EUS-FNB with the modified EUS needle provided histologic tissue cores in the majority of cases and achieved excellentdiagnostic accuracy with few needle passes.
참고문헌 (37)
- Yoshinaga S, "Role of endoscopic ultrasound-guided fine needle aspiration(EUS-FNA)for diagnosis of solid pancreatic masses", Dig Endosc, 23(Suppl 1), pp.29~33 (2011)
- Hewitt MJ, "EUS-guided FNA for diagnosis of solid pancreatic neoplasms : a meta-analysis", Gastrointest Endosc, 75, pp.319~331 (2012)
- Gleeson FC, "False positive endoscopic ultrasound fine needle aspiration cytology : incidence and risk factors", Gut, 59, pp.586~593 (2010)
- Ieni A, "Endoscopic ultrasound-guided fine-needle aspiration cytology in pancreaticobiliary carcinomas : diagnostic efficacy of cell-block immunocytochemistry", Hepatobiliary Pancreat Dis Int, 14, pp.305~312 (2015)
- Yan BM, "Diagnosis of pancreatic gastrointestinal stromal tumor by EUS guided FNA", JOP, 9, pp.192~196 (2008)
- Levy MJ, "Endoscopic ultrasound-guided trucut biopsy of the pancreas : prospects and problems", Pancreatology, 7, pp.163~166 (2007)
- Klapman JB, "Clinical impact of onsite cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration", Am J Gastroenterol, 98, pp.1289~1294 (2003)
- Sandhu DS, "Endoscopic ultrasound with tissue sampling is accurate in the diagnosis and subclassification of gastrointestinal spindle cell neoplasms", Endosc Ultrasound, 6, pp.174~180 (2017)
- Hedenström P, "High clinical impact and diagnostic accuracy of EUS-guided biopsy sampling of subepithelial lesions : a prospective, comparative study", Surg Endosc, 32, pp.1304~1313 (2018)
- Varadarajulu S, "Comparison of EUS-guided 19-gauge Trucut needle biopsy with EUS-guided fine-needle aspiration", Endoscopy, 36, pp.397~401 (2004)
- Cohen MB, "Pancreatic adenocarcinoma : regression analysis to identify improved cytologic criteria", Diagn Cytopathol, 7, pp.341~345 (1991)
- Schwartz DA, "The rate of false-positive results with EUS-guided fine-needle aspiration", Gastrointest Endosc, 56, pp.868~872 (2002)
- Siddiqui AA, "False-positive EUS-guided FNA cytology for solid pancreatic lesions", Gastrointest Endosc, 74, pp.535~540 (2011)
- Gerke H, "Randomized study comparing endoscopic ultrasound-guided Trucut biopsy and fine needle aspiration with high suction", Cytopathology, 21, pp.44~51 (2010)
- Voss M, "Value of endoscopic ultrasound guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses", Gut, 46, pp.244~249 (2000)
- Larghi A, "EUS-guided fine needle tissue acquisition by using high negative pressure suction for the evaluation of solid masses : a pilot study", Gastrointest Endosc, 62, pp.768~774 (2005)
- Larghi A, "EUS-guided fine-needle tissue acquisition by using a 19-gauge needle in a selected patient population : a prospective study", Gastrointest Endosc, 74, pp.504~510 (2011)
- Varadarajulu S, "Assessment of the technical performance of the flexible 19-gauge EUS-FNA needle", Gastrointest Endosc, 76, pp.336~343 (2012)
- Bang JY, "A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition", Endoscopy, 48, pp.339~349 (2016)
- Polkowski M, "Technical aspects of endoscopic ultrasound(EUS)-guided sampling in gastroenterology : European Society of Gastrointestinal Endoscopy(ESGE)technical guideline-March 2017", Endoscopy, 49, pp.989~1006 (2017)
- Sakamoto H, "Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses", J Gastroenterol Hepatol, 24, pp.384~390 (2009)
- Wittmann J, "Endoscopic ultrasound-guided tissue sampling by combined fine needle aspiration and trucut needle biopsy : a prospective study", Cytopathology, 17, pp.27~33 (2006)
- Levy MJ, "Preliminary experience with an EUS-guided trucut biopsy needle compared with EUS-guided FNA", Gastrointest Endosc, 57, pp.101~106 (2003)
- 조창민, "Rescue Endoscopic Ultrasound (EUS)-Guided Trucut Biopsy Following Suboptimal EUS-Guided Fine Needle Aspiration for Mediastinal Lesions", Gut and Liver, 7(2), pp.150~156 (2013), 거트앤리버 소화기연관학회협의회
- Ginès A, "Prospective study of a Trucut needle for performing EUS-guided biopsy with EUS-guided FNA rescue", Gastrointest Endosc, 62, pp.597~601 (2005)
- Kandel P, "EUS-guided fine needle biopsy sampling using a novel fork-tip needle : a case-control study", Gastrointest Endosc, 84, pp.1034~1039 (2016)
- Naveed M, "A Multicenter comparative trial of a novel EUS-guided core biopsy needle(SharkCore™)with the 22-gauge needle in patients with solid pancreatic mass lesions", Endosc Ultrasound, 7, pp.34~40 (2018)
- 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~E979 (2016)
- Witt BL, "Evaluation of the SharkCore® needle for EUS-guided core biopsy of pancreatic neuroendocrine tumors", Endosc Ultrasound, 7, pp.323~328 (2018)
- El Chafic AH, "Comparison of FNA and fine-needle biopsy for EUS-guided sampling of suspected GI stromal tumors", Gastrointest Endosc, 86, pp.510~515 (2017)
- Eloubeidi MA, "A prospective evaluation of an algorithm incorporating routine preoperative endoscopic ultrasound-guided fine needle aspiration in suspected pancreatic cancer", J Gastrointest Surg, 11, pp.813~819 (2007)
- Turner BG, "Diagnosis of pancreatic neoplasia with EUS and FNA : a report of accuracy", Gastrointest Endosc, 71, pp.91~98 (2010)
- van Riet PA, "A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device", Gastrointest Endosc, 89, pp.329~339 (2019)
- Itoi T, "Immunohistochemical analysis of p53and MIB-1 in tissue specimens obtained from endoscopic ultrasonography-guided fine needle aspiration biopsy for the diagnosis of solid pancreatic masses", Oncol Rep, 13, pp.229~234 (2005)
- Brais RJ, "Direct histological processing of EUS biopsies enables rapid molecular biomarker analysis for interventional pancreatic cancer trials", Pancreatology, 12, pp.8~15 (2012)
- Mukai S, "A retrospective histological comparison of EUS-guided fine-needle biopsy using a novel franseen needle and a conventional end-cut type needle", Endosc Ultrasound, 8, pp.50~57 (2019)
- Li H, "Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: a meta-analysis of randomized controlled trials", Medicine(Baltimore), 97, pp.e0207~ (2018)
