Abstract

Background and aims

Endoscopic ultrasound-guided tissue acquisition, including both fine-needle aspiration (EUS-FNA) and fine-needle biopsy (EUS-FNB), has been frequently performed to acquire samples from both pancreatic and non-pancreatic lesions. Still, the impact of the diagnostic yield between FNA and FNB is uncertain. We conducted this study to compare the diagnostic performance and accuracy of the 22-gauge FNA needles with the 22-gauge FNB needles in sampling solid pancreatic and non-pancreatic lesions.

Methods

This is a prospective multicenter study conducted on 465 cases presented with solid pancreatic or non-pancreatic lesions.

Results

Patients were 275 male and 190 females with a mean age of 59 years. Three-hundred twenty-seven patients had solid pancreatic lesions, while 138 had non-pancreatic lesions; 245 cases underwent EUS-FNA, and the remaining 211 cases underwent EUS-FNB. The presence of intact tissue core and sample adequacy was significantly higher in the FNB cases in solid pancreatic and non-pancreatic lesions. Blood contamination was significantly more in cell blocks and smears of EUS-FNA compared to that of EUS-FNB in solid pancreatic and non-pancreatic lesions. Based on histologic assessment of cell block only, EUS-FNB had more diagnostic accuracy (99%) than FNA (61%) (P-value < 0.005). However, cytological diagnosis by smears only showed no significant difference. The combined cytological and histological evaluation had 100% sensitivity, specificity, and accuracy.

Conclusion

EUS-FNA and EUS-FNB have comparable accuracy in diagnosing solid pancreatic and non-pancreatic lesions without ROSE. EUS-FNB is superior to EUS-FNA in acquiring intact tissue core and adequate samples with little blood contamination. Based on histological assessment (cell block/tissue core) only, EUS-FNA has less accuracy than EUS-FNB in diagnosing solid pancreatic lesions.

Details

Title
Comparative diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) for tissue sampling of solid pancreatic and non-pancreatic lesions without ROSE: a prospective multicenter study
Author
Okasha, Hussein Hassan 1   VIAFID ORCID Logo  ; Ahmed, Mohammed Yousri 2   VIAFID ORCID Logo  ; Ahmed, Marwa A. 2   VIAFID ORCID Logo  ; Elenin, Sameh Abou 3   VIAFID ORCID Logo  ; Abdel-latif, Abeer 1   VIAFID ORCID Logo  ; Farouk, Mahmoud 4   VIAFID ORCID Logo  ; Ameen, Mahmoud Gamal 5   VIAFID ORCID Logo  ; El-Habashi, Ahmed Hussein 2   VIAFID ORCID Logo  ; Elshaer, Mahasen Akram 6 ; Alzamzamy, Ahmed Elsayed 3   VIAFID ORCID Logo 

1  Kasr Al-Aini School of Medicine, Internal Medicine Department, Division of Gastroenterology and Hepatology, Cairo, Egypt (GRID:grid.7776.1) (ISNI:0000 0004 0639 9286) 
2  National Cancer Institute, Cairo University, Pathology Department, Cairo, Egypt (GRID:grid.7776.1) (ISNI:0000 0004 0639 9286) 
3  Military Medical Academy, Department of Gastroenterology and Hepatology, Maadi Armed Forces Medical Complex, Cairo, Egypt (GRID:grid.489816.a) (ISNI:0000 0004 0452 2383) 
4  Assiut University, Department of Tropical Medicine and Gastroenterology, Assiut, Egypt (GRID:grid.252487.e) (ISNI:0000 0000 8632 679X) 
5  South Egypt Cancer Institute, Assiut University, Department of Oncological Pathology, Assiut, Egypt (GRID:grid.252487.e) (ISNI:0000 0000 8632 679X) 
6  Ahmed Maher Teaching Hospital, Cairo, Egypt (GRID:grid.7776.1) 
Pages
66
Publication year
2024
Publication date
Dec 2024
Publisher
Springer Nature B.V.
ISSN
11107782
e-ISSN
20909098
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s43162-024-00328-2
ProQuest document ID
3068920983
Copyright
© The Author(s) 2024. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.