Utility of a 21-gauge Menghini-type biopsy needle with the rolling method for an endoscopic ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study.
Utility of a 21-gauge Menghini-type biopsy needle with the rolling method for an endoscopic ultrasound-guided histological diagnosis of autoimmune pancreatitis: a retrospective study.
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DOI：
10.1186/s12876-020-01590-8
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发表时间：
2021-01-07
影响因子：
2.4
通讯作者：
Okada H
中科院分区：
文献类型：
--
作者：
Tsutsumi K;Ueki T;Noma Y;Omonishi K;Ohno K;Kawahara S;Oda T;Kato H;Okada H
通过内窥镜超声(EUS)引导的方法对自身免疫性胰腺炎(AIP)的组织学诊断仍然具有挑战性。我们研究了21号孟希尼型滚动式活检针在AIP组织学诊断中的作用，并与传统的22号活检针进行了比较。对28例AIP患者的组织学确诊率、获得的组织标本面积、AIP的组织病理学诊断率及不良事件进行回顾性分析。使用蒙希尼型针治疗的14名患者(100%)和使用传统22号针(P <； 0.001)治疗的57%的患者(8/14)都成功地完成了明确的组织学诊断。除血液污染外，蒙希尼型穿刺针组织的中位样本面积明显大于常规型穿刺针(6.24.5-8.8vs0.7mm2，P <； 0.001)，每次穿刺针的面积约大4倍(1.4mm2[iqr0.90-2.9vs0.3[iqr：0.1-0.6]mm2/穿刺法，P <； 0.001)。根据国际共识诊断标准，蒙氏针组和常规组分别有86%/29%、%/0%、36%/0%和7%/0%的患者出现淋巴浆细胞浸润、丰富的IgG4阳性细胞、绒毛样纤维化和闭塞性静脉炎。结果，有9名患者(%)接受蒙希尼型针刺治疗，没有一名患者接受常规针治疗(P <； 0.001)，组织病理学诊断为1型急性胰腺炎(水平1或2)。两名术后有轻度胰腺炎的患者经保守治疗后好转，使用蒙希尼型针头治疗的患者没有出血。EUS引导下使用21号Menghini型活检针的滚动法有助于AIP的组织病理学诊断，因为它从胰腺获取了大量高质量的组织。
The histological diagnosis of autoimmune pancreatitis (AIP) by an endoscopic ultrasound (EUS)-guided approach is still challenging. We investigated the utility of the 21-gauge Menghini-type biopsy needle with the rolling method for the histological diagnosis of AIP, in comparison with conventional 22-gauge needles. Among total 28 patients, rate of definitive histological diagnosis, acquired sample area of tissue, rate of histopathological diagnosis of AIP, and adverse events were retrospectively analyzed. Definitive histological diagnoses were successfully accomplished in all 14 patients (100%) treated with a Menghini-type needle, and in 57% of cases (8/14) treated with conventional 22-gauge needles (P < 0.001). The median sample area of the tissue, except for blood contamination, was remarkably larger by the Menghini-type needle than by conventional-type needles (6.2 [IQR, 4.5–8.8] versus 0.7 [IQR, 0.2–2.0] mm2, P < 0.001), and the area per punctures was approximately 4 times larger (1.4 [IQR: 0.9–2.9] versus 0.3 [IQR: 0.1–0.6] mm2/puncture, P < 0.001). Based on the International Consensus Diagnostic Criteria, lymphoplasmacytic infiltration, abundant IgG4-postive cells, storiform fibrosis, and obliterative phlebitis were found in 86%/29%, 64%/0%, 36%/0%, and 7%/0% patients who were treated with the Menghini-type needle and conventional-type needles, respectively. Consequently, histopathological diagnosis with type 1 AIP (lever 1 or 2) was achieved in 9 patients (64%) treated with the Menghini-type needle and in no patient treated with conventional-type needles (P < 0.001). Two patients who had mild post-procedural pancreatitis improved with conservative treatment, and no bleeding occurred in patients treated with the Menghini-type needle. EUS-guided rolling method with the 21-gauge Menghini-type biopsy needle is useful for the histopathological diagnosis of AIP, due to its abundant acquisition of good-quality tissue from the pancreas.
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DOI：
10.1007/s00464-009-0798-3
发表时间：
2010-06-01
影响因子：
3.1
作者：
Ascunce, Gil;Ribeiro, Afonso;Levi, Joe U.
通讯作者：
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影响因子：
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7.7
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影响因子：
7.7
作者：
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