■标准抽吸技术(SST),慢拉技术(SPT),EUS-FNA的湿吸技术(WEST)旨在提高实性和实性囊性病变的诊断率。我们进行了一个多中心,prospective,随机交叉试验比较SST,SPT,使用22G针头对标本质量和诊断准确性的评价。
2017年12月至2019年8月在四家三级医院转诊的实性或实性囊性病变患者被认为是合格的。所有病变均使用22G针以随机顺序连续进行的三种技术进行采样。主要结果是通过每种技术获得的关于血液污染的样本的质量,用于诊断的组织完整性和细胞性,在预定义的尺度上分级。次要结果是EUS-FNA的诊断率和不良事件的发生率。临床试验。gov注册号:NCT03567863。
■总共300名患者(平均年龄,60.6年,188名男子)报名参加。WEST优于SST(3.67±1.57,P=0.018)(平均得分为4.02±1.51),但在总体标本质量评价方面与SPT(3.83±1.55,P=0.370)相当。与SST和SPT相比,WEST产生了更好的组织完整性(1.42±0.74)和更高的细胞性(1.32±0.80)。在避免血液污染方面,SPT(1.43±0.69)优于SST(1.27±0.72,P=0.004)和WEST(1.28±0.71,P=0.006)。WEST实现了74.7%的诊断准确率,高于SST(64.4%,P=0.007)和SPT(65.0%,P=0.012)。1例出血事件发生在胰腺病变。
■WEST在样本的整体质量上与SPT相当,优于SST,并获得了最高的诊断产量。
UNASSIGNED: Standard suction technique (SST), slow-pull technique (SPT), and wet suction technique (WEST) of EUS-FNA are designed to improve the diagnostic yields of solid and solid-cystic lesions. We conducted a multicenter, prospective, randomized crossover trial to compare SST, SPT, and WEST on specimen quality and diagnostic accuracy using a 22G needle.
UNASSIGNED: Patients with solid or solid-cystic lesions referred for EUS-FNA at four tertiary hospitals from December 2017 to August 2019 were considered eligible. All lesions were sampled using a 22G needle by the three techniques performed consecutively in a randomized order. The primary outcome was quality of the specimen acquired by each technique regarding blood contamination, tissue integrity and cellularity for diagnosis, graded on a predefined scale. The secondary outcomes were the diagnostic yield of EUS-FNA and the incidence of adverse events. ClinicalTrial. gov registration number: NCT03567863.
UNASSIGNED: A total of 300 patients (mean age, 60.6 years, 188 men) were enrolled. WEST was superior (mean score 4.02 ± 1.51) over SST (3.67 ± 1.57, P = 0.018), but comparable to SPT (3.83 ± 1.55, P = 0.370) in overall specimen quality evaluation. WEST produced better tissue integrity (1.42 ± 0.74) and higher cellularity (1.32 ± 0.80) than SST and SPT. SPT (1.43 ± 0.69) was superior to SST (1.27 ± 0.72, P = 0.004) and WEST (1.28 ± 0.71, P = 0.006) in avoiding blood contamination. WEST achieved a diagnostic accuracy of 74.7%, higher than SST (64.4%, P = 0.007) and SPT (65.0%, P = 0.012). One bleeding event occurred with a pancreatic lesion.
UNASSIGNED: WEST was comparable to SPT and superior to SST in the overall quality of the specimen and achieved highest diagnostic yield.