Utility of Endoscopic Ultrasound-Guided Biopsy for Next-Generation Sequencing of Pancreatic Exocrine Malignancies
Utility of Endoscopic Ultrasound-Guided Biopsy for Next-Generation Sequencing of Pancreatic Exocrine Malignancies
复制标题
DOI：
10.1097/mpa.0000000000001117
复制
发表时间：
2018-09-01
期刊：
影响因子：
2.9
通讯作者：
Hendifar, Andrew E.
中科院分区：
文献类型：
--
作者：
Larson, Brent K.;Tuli, Richard;Hendifar, Andrew E.
目的超声内窥镜引导下细针穿刺活检是胰腺恶性肿瘤的标准诊断方法。肿瘤学家越来越多地使用肿瘤基因组分析进行管理。FNB/A组织对下一代测序(NGS)的充分性尚未进行评估。方法对76例胰腺外分泌恶性肿瘤活检标本进行充分性评估，并与其他肿瘤/活检组织学特征进行比较。结果76例标本中22例(29%)不充分，其中16例(30%)FNB不充分，4例(57%)FNAs不充分。在所有样本(P=0.0047.0 5)和FNB(P=0.0 5)中，较大口径的针头与充分性有关。与胰腺标本相比，转移性标本更有可能适用于非小细胞肺癌(P=0.0357)。尽管这一趋势不显著，但经皮活检比超声引导下的活检术更有可能是足够的(P=0.0558)。其他肿瘤/活检特征与充分性无关。结论内窥镜US FNA和FNB提供相似的NGS充分率。对于NGS，经皮活检可获得的转移性病变可能比原发灶的EUS FNB/A更可取。所有的活组织检查，包括EUS FNB，使用更大口径的针头更有可能成功。
Objectives Endoscopic ultrasound-guided fine-needle biopsy and aspiration (EUS FNB/A) are the standard diagnostic tests for pancreatic malignancies. Oncologists increasingly use tumor genomic analysis for management. Adequacy of FNB/A tissue for next-generation sequencing (NGS) has not been evaluated. This study examined FNB/A and other biopsy types for features that might predict adequacy for NGS.Methods Seventy-six pancreatic exocrine malignancy biopsies submitted for NGS were assessed for adequacy, which was compared with other tumor/biopsy features.Results Twenty-two (29%) of 76 samples were inadequate, including 16 (30%) of 54 FNBs and 4 (57%) of 7 FNAs. Larger-gauge needles were associated with adequacy in all samples (P = 0.0047) and in FNBs (P = 0.05). Metastatic samples were more likely to be adequate for NGS compared with pancreatic samples (P = 0.0357). Percutaneous biopsies were more likely to be adequate than EUS-guided FNB/As, although this trend was not significant (P = 0.0558). Other tumor/biopsy characteristics were not associated with adequacy.Conclusions Endoscopic US FNA and FNB provided similar NGS adequacy rates. Metastatic lesions accessible by percutaneous biopsy may be preferable to EUS FNB/A of primary lesions for obtaining tissue for NGS. All biopsies, including EUS FNB, were more likely to be successful using larger-gauge needles.