Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study
- Authors
- Lee, Yun Nah; Moon, Jong Ho; Kim, Hee Kyung; Choi, Hyun Jong; Choi, Moon Han; Kim, Dong Choon; Lee, Tae Hoon; Cha, Sang-Woo; Cho, Young Deok; Park, Sang-Heum
- Issue Date
- Dec-2014
- Publisher
- Georg Thieme Verlag
- Keywords
- Core biopsy needle; endoscopic ultrasound
- Citation
- Endoscopy, v.46, no.12, pp 1056 - 1062
- Pages
- 7
- Journal Title
- Endoscopy
- Volume
- 46
- Number
- 12
- Start Page
- 1056
- End Page
- 1062
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/11685
- DOI
- 10.1055/s-0034-1377558
- ISSN
- 0013-726X
1438-8812
- Abstract
- Background and study aims: An endoscopic ultrasound (EUS)-guided fine needle biopsy (EUS-FNB) device using a core biopsy needle was developed to improve diagnostic accuracy by simultaneously obtaining cytological aspirates and histological core samples. We prospectively compared the diagnostic accuracy of EUS-FNB with standard EUS-guided fine needle aspiration (EUS-FNA) in patients with solid pancreatic masses. Patients and methods: Between January 2012 and May 2013, consecutive patients with solid pancreatic masses were prospectively enrolled and randomized to undergo EUS-FNB using a core biopsy needle or EUS-FNA using a standard aspiration needle at a single tertiary center. The specimen was analyzed by onsite cytology, Papanicolaou-stain cytology, and histology. The main outcome measure was diagnostic accuracy for malignancy. The secondary outcome measures were: the median number of passes required to establish a diagnosis, the proportion of patients in whom the diagnosis was established with each pass, and complication rates. Results: The overall accuracy of combining onsite cytology with Papanicolaou-stain cytology and histology was not significantly different for the FNB (n=58) and FNA (n=58) groups (98.3% [95% CI 94.9%-100%] vs. 94.8% [95% CI 91.9%-100%]; P=0.671). Compared with FNA, FNB required a significantly lower median number of needle passes to establish a diagnosis (1.0 vs. 2.0; P<0.001). On subgroup analysis of 111 patients with malignant lesions, the proportion of patients in whom malignancy was diagnosed on the first pass was significantly greater in the FNB group (72.7% vs. 37.5%; P<0.001). Conclusions: The overall accuracy of FNB and FNA in patients with solid pancreatic masses was comparable; however, fewer passes were required to establish the diagnosis of malignancy using FNB.
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