Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions
Endoscopic ultrasound-guided fine needle aspiration and biopsy using a 22-gauge needle with side fenestration in pancreatic cystic lesions
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DOI：
10.1016/j.dld.2013.06.008
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发表时间：
2014-01-01
影响因子：
4.5
通讯作者：
Fabbri, Carlo
中科院分区：
文献类型：
--
作者：
Barresi, Luca;Tarantino, Ilaria;Fabbri, Carlo
背景：超声内镜引导下细针穿刺细胞学诊断的敏感性和充分性较低。一种新设计的内窥镜超声引导细针穿刺活检装置，具有侧开窗，现在是可用的。目的：我们进行了一项研究，目的是评估22号针侧开窗用于胰腺囊性病变的内窥镜超声细针抽吸和活检的可行性，安全性和诊断率。方法：58例60个胰腺囊性病变连续转诊进行内镜超声引导细针抽吸的患者入组前瞻性双中心研究，并使用22号侧开窗针进行细针抽吸和活检。所有病例的细针抽吸和活检在技术上都是可行的。在39/60（65%）例胰腺囊性病变中，标本足以进行细胞组织学评估。在有实体成分的病变和恶性病变中，充分性分别为94.4%（p = 0.0149）和100%（p = 0.0069）。在18/39例（46.1%）病例中，样本足以进行组织学评价。结论：22 G侧孔细针穿刺活检是可行的，且上级优于传统内镜超声引导下囊液细针穿刺细胞学检查，尤其是对胰腺囊性病变伴实性成分或恶性病变的诊断率更高，且并发症不增加。(C)2013 Editrice Gastroenterology Italiana S.r.l.由爱思唯尔有限公司出版。保留所有权利。
Background: Cytologic diagnosis by endoscopic ultrasound-guided fine needle aspiration is associated with low sensitivity and adequacy. A newly designed endoscopic ultrasound-guided fine needle biopsy device, endowed with a side fenestration, is now available.Aims: We carried out a study with the aim of evaluating the feasibility, safety, and diagnostic yield of the 22-gauge needle with side fenestration for endoscopic ultrasound fine needle aspiration and biopsy of pancreatic cystic lesions.Methods: 58 patients with 60 pancreatic cystic lesions consecutively referred for endoscopic ultrasound guided-fine needle aspiration were enrolled in a prospective, dual centre study, and underwent fine needle aspiration and biopsy with the 22-gauge needle with side fenestration.Results: Fine needle aspiration and biopsy was technically feasible in all cases. In 39/60 (65%) pancreatic cystic lesions, the specimens were adequate for cyto-histologic assessment. In lesions with solid components, and in malignant lesions, adequacy was 94.4% (p = 0.0149) and 100% (p = 0.0069), respectively. Samples were adequate for histologic evaluation in 18/39 (46.1%) cases. There were only 2 (3.3%) mild complications.Conclusions: Fine needle aspiration and biopsy with the 22-gauge needle with side fenestration is feasible, and superior to conventional endoscopic ultrasound-guided fine needle aspiration cytology from cystic fluid, particularly in pancreatic cystic lesions with solid component or malignancy, with a higher diagnostic yield and with no increase in complication rate. (C) 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.