Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions - 20/07/12
Reprint requests: Shyam Varadarajulu, MD, Director of Endoscopy, Basil I. Hirschowitz Endoscopic Center of Excellence, University of Alabama at Birmingham, JT 664, 619-19th Street S, Birmingham, AL 35294-0007Résumé |
Background |
To overcome limitations of cytology, biopsy needles have been developed to procure histologic samples during EUS.
Objective |
To compare 22-gauge (G) FNA and 22G biopsy needles (FNB) for EUS-guided sampling of solid pancreatic masses.
Design |
Randomized trial.
Setting |
Tertiary-care medical center.
Patients |
This study involved 56 patients with solid pancreatic masses.
Intervention |
Sampling of pancreatic masses by using 22G FNA or 22G FNB devices.
Main Outcome Measurements |
Compare the median number of passes required to establish the diagnosis, diagnostic sufficiency, technical performance, complication rates, procurement of the histologic core, and quality of the histologic specimen.
Results |
A total of 28 patients were randomized to the FNA group and 28 to the FNB group. There was no significant difference in median number of passes required to establish the diagnosis (1 [interquartile range 1-2.5] vs 1 [interquartile range 1-1]; P = .21), rates of diagnostic sufficiency (100% vs 89.3%; P = .24), technical failure (0 vs 3.6%; P = 1.0), or complications (3.6% for both) between FNA and FNB needles, respectively. Patients in whom diagnosis was established in passes 1, 2, and 3 were 64.3% versus 67.9%, 10.7% versus 17.9%, and 25% versus 3.6%, respectively, for FNA and FNB cohorts. There was no significant difference in procurement of the histologic core (100% vs 83.3%; P = .26) or the presence of diagnostic histologic specimens (66.7% vs 80%; P = .66) between FNA and FNB cohorts, respectively.
Limitations |
Only pancreatic masses were evaluated.
Conclusion |
Diagnostic sufficiency, technical performance, and safety profiles of FNA and FNB needles are comparable. There was no significant difference in yield or quality of the histologic core between the 2 needle types. (Clinical trial registration number: NCT01394159.)
Le texte complet de cet article est disponible en PDF.Abbreviations : EUS-FNA, FNB, HBSS, TNB
Plan
| DISCLOSURE: S. Varadarajulu is a consultant for Boston Scientific. No other financial relationships relevant to this publication were disclosed. |
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| See CME section; p. 396. |
Vol 76 - N° 2
P. 321-327 - août 2012 Retour au numéro
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