In memoriam: Fine-needle aspiration, birth: Fine-needle biopsy: The changing trend in endoscopic ultrasound-guided tissue acquisition.


Journal

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
ISSN: 1443-1661
Titre abrégé: Dig Endosc
Pays: Australia
ID NLM: 9101419

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 09 06 2018
accepted: 21 09 2018
pubmed: 27 9 2018
medline: 8 8 2019
entrez: 27 9 2018
Statut: ppublish

Résumé

Fine-needle aspiration (FNA) cytology has been the preferred technique for procuring tissue at endoscopic ultrasound (EUS) procedures for the past 25 years. To overcome some of the limitations of FNA cytology, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. Main objective was to compare the diagnostic yield of FNB compared to FNA for both onsite and offsite specimen assessment. A retrospective study was conducted at a single tertiary referral center to evaluate the outcomes of FNA and FNB over a 4-year period. EUS-guided tissue sampling was carried out using 22- or 25-G FNA needles from 2014 to 2015, and 22-G FNB needle was used from 2016 to 2017. Of 3020 patients undergoing EUS-guided sampling of solid mass lesions (pancreatic masses 71.3%, other lesions 28.7%), FNA was carried out in 68.9% and FNB in 31.1%. Median number of passes required for diagnostic adequacy on rapid onsite evaluation was significantly lower for FNB compared to FNA (1 [IQR: 1-2] vs 2 [IQR 1-3], P < 0.001). Diagnostic yield on cell block was also significantly superior with FNB compared to FNA (92.3 vs 71.1%, P < 0.001). The superior performance of FNB over FNA was observed for both pancreatic (P < 0.001) and non-pancreatic lesions (P < 0.001). Given these promising findings, in the future, EUS-guided FNB will likely be the preferred technique for sampling of solid mass lesions.

Sections du résumé

BACKGROUND AND AIM OBJECTIVE
Fine-needle aspiration (FNA) cytology has been the preferred technique for procuring tissue at endoscopic ultrasound (EUS) procedures for the past 25 years. To overcome some of the limitations of FNA cytology, fine-needle biopsy (FNB) has been recently developed to yield histological tissue. Main objective was to compare the diagnostic yield of FNB compared to FNA for both onsite and offsite specimen assessment.
METHODS METHODS
A retrospective study was conducted at a single tertiary referral center to evaluate the outcomes of FNA and FNB over a 4-year period. EUS-guided tissue sampling was carried out using 22- or 25-G FNA needles from 2014 to 2015, and 22-G FNB needle was used from 2016 to 2017.
RESULTS RESULTS
Of 3020 patients undergoing EUS-guided sampling of solid mass lesions (pancreatic masses 71.3%, other lesions 28.7%), FNA was carried out in 68.9% and FNB in 31.1%. Median number of passes required for diagnostic adequacy on rapid onsite evaluation was significantly lower for FNB compared to FNA (1 [IQR: 1-2] vs 2 [IQR 1-3], P < 0.001). Diagnostic yield on cell block was also significantly superior with FNB compared to FNA (92.3 vs 71.1%, P < 0.001). The superior performance of FNB over FNA was observed for both pancreatic (P < 0.001) and non-pancreatic lesions (P < 0.001).
CONCLUSION CONCLUSIONS
Given these promising findings, in the future, EUS-guided FNB will likely be the preferred technique for sampling of solid mass lesions.

Identifiants

pubmed: 30256458
doi: 10.1111/den.13280
doi:

Types de publication

Journal Article

Langues

eng

Pagination

197-202

Informations de copyright

© 2018 Japan Gastroenterological Endoscopy Society.

Auteurs

Ji Young Bang (JY)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Sachin Kirtane (S)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Konrad Krall (K)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Udayakumar Navaneethan (U)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Muhammad Hasan (M)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Robert Hawes (R)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

Shyam Varadarajulu (S)

Center for Interventional Endoscopy, Florida Hospital, Orlando, USA.

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