Abstract：
A direct comparison between endoscopic ultrasound (EUS) fine-needle biopsy (FNB) and current endoscopic biopsy techniques in patients with subepithelial lesions (SELs) is still lacking. Aim of this multicenter study was to compare the diagnostic performance and safety profile between EUS-FNB and bite-on-bite jumbo biopsy.
Out of 416 patients undergoing endoscopic sampling of SELs between 2017 and 2021, after propensity score matching two groups were compared: 120 undergoing EUS-FNB and 120 sampled with bite-on-bite jumbo biopsy. Primary outcome was sample adequacy. Secondary outcomes were diagnostic accuracy, sensitivity, specificity, and adverse events.
Median age was 61 years and most patients were male in both groups. Final diagnosis was GIST in 65 patients (54.1%) in the EUS-FNB group and 62 patients in the bite-on-bite biopsy group (51.6%; p = 0.37). Sample adequacy was significantly higher in the EUS-FNB group as compared to the bite-on-bite biopsy group (94.1% versus 77.5%, p<0.001). EUS-FNB outperformed bite-on-bite biopsy also in terms of diagnostic accuracy (89.3% versus 67.1%, p<0.001) and sensitivity (89% vs 64.5%; p<0.001), whereas specificity was 100% in both groups (p = 0.89). These findings were confirmed in subgroup analysis according to SEL location, final diagnosis, and wall layers of the sampled SEL. Adverse event rate was 6.6% in the EUS-FNB group and 30% in the bite-on-bite biopsy group (p<0.001).
EUS-FNB outperforms bite-on-bite biopsy both in terms of diagnostic yield and safety profile.
Out of 416 patients undergoing endoscopic sampling of SELs between 2017 and 2021, after propensity score matching two groups were compared: 120 undergoing EUS-FNB and 120 sampled with bite-on-bite jumbo biopsy. Primary outcome was sample adequacy. Secondary outcomes were diagnostic accuracy, sensitivity, specificity, and adverse events.
Median age was 61 years and most patients were male in both groups. Final diagnosis was GIST in 65 patients (54.1%) in the EUS-FNB group and 62 patients in the bite-on-bite biopsy group (51.6%; p = 0.37). Sample adequacy was significantly higher in the EUS-FNB group as compared to the bite-on-bite biopsy group (94.1% versus 77.5%, p<0.001). EUS-FNB outperformed bite-on-bite biopsy also in terms of diagnostic accuracy (89.3% versus 67.1%, p<0.001) and sensitivity (89% vs 64.5%; p<0.001), whereas specificity was 100% in both groups (p = 0.89). These findings were confirmed in subgroup analysis according to SEL location, final diagnosis, and wall layers of the sampled SEL. Adverse event rate was 6.6% in the EUS-FNB group and 30% in the bite-on-bite biopsy group (p<0.001).
EUS-FNB outperforms bite-on-bite biopsy both in terms of diagnostic yield and safety profile.
摘要：
目的：在上皮下病变（SEL）患者中，内镜超声（EUS）细针活检（FNB）与当前内镜活检技术之间的直接比较仍然缺乏。这项多中心研究的目的是比较EUS-FNB和按咬大型活检之间的诊断性能和安全性。
方法：在2017年至2021年期间接受内镜下SEL采样的416例患者中，在倾向评分匹配两组后进行比较：120例接受EUS-FNB，120例接受咬伤大活检。主要结果是样本充足性。次要结果是诊断准确性，灵敏度,特异性，和不良事件。
结果：中位年龄为61岁，两组中大多数患者均为男性。最终诊断为GIST，EUS-FNB组65例（54.1%），咬合活检组62例（51.6%；p=0.37）。与按咬活检组相比，EUS-FNB组的样本充分性明显更高（94.1％对77.5％，p<0.001)。EUS-FNB在诊断准确性方面也优于咬咬活检（89.3％对67.1％，p<0.001)和灵敏度(89%vs64.5%；p<0.001)，而两组的特异性均为100%(p=0.89).这些发现在根据SEL位置的亚组分析中得到证实，最终诊断,和采样SEL的壁层。EUS-FNB组的不良事件发生率为6.6％，咬伤活检组为30％（p<0.001）。
结论：EUS-FNB在诊断率和安全性方面均优于咬伤活检。
方法：在2017年至2021年期间接受内镜下SEL采样的416例患者中，在倾向评分匹配两组后进行比较：120例接受EUS-FNB，120例接受咬伤大活检。主要结果是样本充足性。次要结果是诊断准确性，灵敏度,特异性，和不良事件。
结果：中位年龄为61岁，两组中大多数患者均为男性。最终诊断为GIST，EUS-FNB组65例（54.1%），咬合活检组62例（51.6%；p=0.37）。与按咬活检组相比，EUS-FNB组的样本充分性明显更高（94.1％对77.5％，p<0.001)。EUS-FNB在诊断准确性方面也优于咬咬活检（89.3％对67.1％，p<0.001)和灵敏度(89%vs64.5%；p<0.001)，而两组的特异性均为100%(p=0.89).这些发现在根据SEL位置的亚组分析中得到证实，最终诊断,和采样SEL的壁层。EUS-FNB组的不良事件发生率为6.6％，咬伤活检组为30％（p<0.001）。
结论：EUS-FNB在诊断率和安全性方面均优于咬伤活检。
