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首页> 外文期刊>Surgical Endoscopy >Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: A multicenter prospective cohort study
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Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: A multicenter prospective cohort study

机译：一种新型22口径组织学EUS针在胰腺肿块患者中的可行性和产量：一项多中心前瞻性队列研究

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Background: The option of obtaining tissue samples for histological examination during endoscopic ultrasound (EUS) has theoretical and practical advantages over cytology alone. The aim of this study was to evaluate the feasibility, yield, and diagnostic accuracy of a new EUS 22-G fine-needle biopsy (FNB) device in patients with solid pancreatic masses in a multicenter, prospective study. Methods: All consecutive patients who underwent EUS-guided fine-needle biopsy (EUS-FNB) using a newly developed 22-G FNB needle between September 2010 and October 2010 were enrolled in the study. The EUS-FNB technique was standardized among the participating endoscopists. Only a single needle pass was performed. Results: A total of 61 patients (35 males, mean age 64.2 ± 12.4 years) with solid pancreatic masses with a mean size of 32.4 ± 8.5 mm (range 13-90 mm) participated. EUS-FNB was performed through the duodenum in 35 cases (57.4 %) and was technically feasible in all but one of the 61 (98.4 %) patients without complications. Tissue samples for histological examination were obtained from 55 patients (90.2 %) and were deemed adequate in 54 of the cases (88.5 %). The diagnoses established by EUS-FNB were adenocarcinoma (39 patients), neuroendocrine tumors (5), chronic focal pancreatitis (5), sarcoma (2), lymphoma (1), acinar cellular tumor (1), and pancreatic metastasis from renal cell carcinoma (1). In an intention-to-treat (ITT) analysis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the histologic diagnosis of a pancreatic mass were 87.5, 100, 100, 41.7, and 88.5 %, respectively. Conclusions: EUS-FNB was technically feasible in 98 % of patients with a solid pancreatic mass. A suitable sample for histological evaluation was obtained in 88.5 % of the cases after only one single needle pass. The apparently low negative predictive value is likely to be improved by increasing the number of needle passes.
机译：背景：内镜超声检查（EUS）期间获取组织样本进行组织学检查的选择具有比仅细胞学检查更具有理论和实践优势。这项研究的目的是在一项多中心，前瞻性研究中评估新型EUS 22-G细针穿刺活检（FNB）装置在实体胰腺肿块患者中的可行性，产率和诊断准确性。方法：2010年9月至2010年10月之间使用新开发的22-G FNB针进行EUS引导的细针穿刺活检（EUS-FNB）的所有连续患者入选本研究。 EUS-FNB技术在参与的内镜医师中已标准化。仅执行一次针刺。结果：总共61例（平均年龄64.2±12.4岁的男性患者）35例，平均大小为32.4±8.5毫米（范围13-90毫米），有实性胰腺肿块。 EUS-FNB在十二指肠中进行了35例（57.4％），除61例（98.4％）无并发症的一名患者外，在所有患者中在技术上都是可行的。从55例患者（90.2％）获得用于组织学检查的组织样本，其中54例（88.5％）被认为足够。由EUS-FNB建立的诊断为腺癌（39例），神经内分泌肿瘤（5），慢性局灶性胰腺炎（5），肉瘤（2），淋巴瘤（1），腺泡细胞瘤（1）和肾细胞胰腺转移癌（1）。在意向性治疗（ITT）分析中，胰腺肿块组织学诊断的敏感性，特异性，阳性预测值，阴性预测值和准确性分别为87.5％，100％，100％，41.7％和88.5％。结论：EUS-FNB技术在98％的实体胰腺肿块患者中是可行的。仅一根针通过后，在88.5％的病例中获得了用于组织学评估的合适样品。显然，较低的阴性预测值可能会通过增加针刺次数来改善。

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