Abstract：
OBJECTIVE: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become the procedure of choice to obtain samples from pancreatic lesions. However, it still has limitations affecting its diagnostic yield. The endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle was developed to allow acquisition of histological core. We conducted this study to compare the diagnostic yield of the Echotip 22Gauge FNA needle with the 22Gauge acquire FNB needle in pancreatic and non-pancreatic lesions.
METHODS: This prospective study was carried out on 100 cases of pancreatic and non-pancreatic lesions referred to El-Ebrashi unit of Gastroenterology and Hepatology, internal medicine department, Kasr Al-Aini hospital. The patients included were then randomized for sampling using either the standard Echotip 22Gauge FNA needle or 22Gauge acquire FNB needle.
RESULTS: Patients were 57 males and 43 females with a mean age of 58±15 years. Seventy-eight patients had pancreatic lesions, while twenty-two patients had non-pancreatic lesions. Half of the patients (50 cases) underwent EUS-FNA, and the other half (50 cases) underwent EUS-FNB. The presence of adequate tissue core was significantly higher in the FNB group. In contrast, smear cellularity was not significantly different between both groups. FNB had more sensitivity and accuracy depending on cell block/tissue core examination only for diagnosing pancreatic lesions. Blood contamination was higher in cell blocks of the FNA group. The sensitivity, specificity, and accuracy in the combined cytologic and histologic evaluation were 100%. Based on smear only or tissue only, the specificity was 100%, but the sensitivity and accuracy were decreased in both techniques. No complications were reported in both techniques.
CONCLUSIONS: EUS-guided FNA and FNB are safe with comparable diagnostic accuracy in pancreatic and non-pancreatic lesions. FNB improved the histopathological quality of specimens with little blood contamination. Depending on tissue examination only in diagnosing pancreatic lesions, FNB had more sensitivity and diagnostic accuracy.
METHODS: This prospective study was carried out on 100 cases of pancreatic and non-pancreatic lesions referred to El-Ebrashi unit of Gastroenterology and Hepatology, internal medicine department, Kasr Al-Aini hospital. The patients included were then randomized for sampling using either the standard Echotip 22Gauge FNA needle or 22Gauge acquire FNB needle.
RESULTS: Patients were 57 males and 43 females with a mean age of 58±15 years. Seventy-eight patients had pancreatic lesions, while twenty-two patients had non-pancreatic lesions. Half of the patients (50 cases) underwent EUS-FNA, and the other half (50 cases) underwent EUS-FNB. The presence of adequate tissue core was significantly higher in the FNB group. In contrast, smear cellularity was not significantly different between both groups. FNB had more sensitivity and accuracy depending on cell block/tissue core examination only for diagnosing pancreatic lesions. Blood contamination was higher in cell blocks of the FNA group. The sensitivity, specificity, and accuracy in the combined cytologic and histologic evaluation were 100%. Based on smear only or tissue only, the specificity was 100%, but the sensitivity and accuracy were decreased in both techniques. No complications were reported in both techniques.
CONCLUSIONS: EUS-guided FNA and FNB are safe with comparable diagnostic accuracy in pancreatic and non-pancreatic lesions. FNB improved the histopathological quality of specimens with little blood contamination. Depending on tissue examination only in diagnosing pancreatic lesions, FNB had more sensitivity and diagnostic accuracy.
摘要：
目的：内镜超声引导下细针抽吸术（EUS-FNA）已成为从胰腺病变中获取样本的首选方法。然而,它仍然有局限性，影响其诊断率。开发了内窥镜超声引导的细针活检（EUS-FNB）针以允许获取组织学核心。我们进行了这项研究，以比较Echotip22GaugeFNA针与22Gauge获得FNB针在胰腺和非胰腺病变中的诊断能力。
方法：这项前瞻性研究是针对100例胰腺和非胰腺病变，涉及胃肠病学和肝病学的El-Ebrashi单元，内科，KasrAl-Aini医院.然后使用标准Echotip22GaugeFNA针或22Gauge采集FNB针将所包括的患者随机进行采样。
结果：患者男性57例，女性43例，平均年龄58±15岁。78例患者有胰腺病变,而22例患者有非胰腺病变。一半的患者（50例）接受了EUS-FNA，另一半（50例）接受了EUS-FNB。在FNB组中存在充足的组织核心显著较高。相比之下,两组之间的涂片细胞数没有显着差异。仅通过细胞块/组织核心检查诊断胰腺病变，FNB具有更高的敏感性和准确性。FNA组细胞块中血液沾染较高。敏感性,特异性，细胞学和组织学联合评估的准确性为100%.仅基于涂片或仅基于组织，特异性为100%，但两种技术的灵敏度和准确度均有所下降。两种技术均未报告并发症。
结论：EUS引导的FNA和FNB在胰腺和非胰腺病变中具有相当的诊断准确性是安全的。FNB改善了标本的组织病理学质量，血液污染很少。仅在诊断胰腺病变时进行组织检查，FNB具有更高的敏感性和诊断准确性。
方法：这项前瞻性研究是针对100例胰腺和非胰腺病变，涉及胃肠病学和肝病学的El-Ebrashi单元，内科，KasrAl-Aini医院.然后使用标准Echotip22GaugeFNA针或22Gauge采集FNB针将所包括的患者随机进行采样。
结果：患者男性57例，女性43例，平均年龄58±15岁。78例患者有胰腺病变,而22例患者有非胰腺病变。一半的患者（50例）接受了EUS-FNA，另一半（50例）接受了EUS-FNB。在FNB组中存在充足的组织核心显著较高。相比之下,两组之间的涂片细胞数没有显着差异。仅通过细胞块/组织核心检查诊断胰腺病变，FNB具有更高的敏感性和准确性。FNA组细胞块中血液沾染较高。敏感性,特异性，细胞学和组织学联合评估的准确性为100%.仅基于涂片或仅基于组织，特异性为100%，但两种技术的灵敏度和准确度均有所下降。两种技术均未报告并发症。
结论：EUS引导的FNA和FNB在胰腺和非胰腺病变中具有相当的诊断准确性是安全的。FNB改善了标本的组织病理学质量，血液污染很少。仅在诊断胰腺病变时进行组织检查，FNB具有更高的敏感性和诊断准确性。
