背景:内窥镜超声引导下细针穿刺活检(EUS-FNA,-FNB)是胰腺病变组织诊断的主要依据。传统上,进行FNA以获得细胞学和组织学(如果可从穿刺获得)。自从他们的出现,然而,FNB针主要用于获得组织学标本的核心活检。
目的:我们旨在评估通过FNA和FNB针获得的细胞学产量。
方法:进行了一项回顾性研究,包括通过EUS-FNA/FNB针头获得的所有诊断为胰腺腺癌的患者。
结果:总体而言,227名患者被包括在内。其中,85例患者接受FNB,与142例FNA患者相比。FNB组的平均年龄为70.46±11.29岁,与FNA组的71.44±11.80相比,P=0.57。值得注意的是,细胞学分析在两组中均诊断为恶性肿瘤(FNB组为69.4%,vs.FNA组为65.5%)。FNB组细胞学与组织学的相容性为76.5%,FNA组为76.1%(P=0.69)。FNA获得的细胞学和FNB之间的一致水平,对比两针获得的组织学,中度(κ=0.48,95%CI0.39-0.57)。同样,FNB组细胞学和组织学的一致性水平也中等(kappa=0.5,95%CI0.36~0.64).
结论:与两种针头的组织学评估相比,细胞学评估产生了相同的表现。我们建议用FNB针在胰腺实性病变穿刺中获取细胞学标本。
BACKGROUND: Endoscopic ultrasound-guided fine needle aspiration and biopsy (EUS-FNA, -
FNB) are the mainstay for tissue diagnosis of pancreatic lesions. Traditionally, FNA was performed for obtaining cytology and also histology if available from the puncture. Since their advent, however, FNB needles have been intended mainly to obtain core biopsies for histological specimens.
OBJECTIVE: We aimed to assess the yield of cytology obtained via both FNA and
FNB needles.
METHODS: A retrospective study was performed including all patients who were diagnosed with pancreatic adenocarcinoma obtained via EUS-FNA/FNB needles.
RESULTS: Overall, 227 patients were included. Of them, 85 patients underwent
FNB, versus 142 patients who had FNA. The average age in the
FNB group was 70.46 ± 11.29 years, versus 71.44 ± 11.80 in the FNA group, P = 0.57. Notably, cytological analysis diagnosed malignancy equally in both groups (69.4% in the FNB group, vs. 65.5% in the FNA group). The compatibility rate of cytology with histology was 76.5% in the FNB group, versus 76.1% in the FNA group (P = 0.69). The agreement level between cytology obtained by FNA and FNB, versus histology obtained by both needles, was moderate (kappa = 0.48, 95% CI 0.39-0.57). Similarly, the agreement level between cytology and histology in the FNB group was moderate as well (kappa = 0.5, 95% CI 0.36-0.64).
CONCLUSIONS: Cytological assessment yielded an equal performance as compared to histological assessment with both needles. We recommend obtaining cytology specimens in pancreatic solid lesion puncture by
FNB needle.