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Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions:A multi-center analysis

World Journal of Clinical Cases 2021年第34期9卷 10507-10517页

作者： Diogo Turiani Hourneaux Moura Thomas R McCarty Pichamol Jirapinyo Igor Braga Ribeiro Galileu Ferreira Ayala Farias Antonio Coutinho Madruga-Neto Marvin Ryou Christopher C Thompson Gastrointestinal Endoscopy Unit University of Sao Paulo School of MedicineSão PauloSP 05403-010Brazil Division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical SchoolBostonMA 02115United States Division of Gastrointestinal Endoscopy University of São Paulo Medical SchoolSão PauloSP 01246-903Brazil

BACKGROUND While endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)is considered a preferred technique for tissue sampling for solid lesions,fine needle biopsy(FNB)has recently been developed.AIM To compare the accuracy of FNB vs FNA in determining the diagnosis of solid lesions.METHODS A retrospective,multi-center study of EUS-guided tissue sampling using FNA vs FNB needles.Measured outcomes included diagnostic test characteristics(i.e.,sensitivity,specificity,accuracy),use of rapid on-site evaluation(ROSE),and adverse events.Subgroup analyses were performed by type of lesion and diagnostic yield with or without ROSE.A multivariable logistic regression was also performed.RESULTS A total of 1168 patients with solid lesions(n=468 FNA;n=700 FNB)underwent EUS-guided sampling.Mean age was 65.02±12.13 years.Overall,sensitivity,specificity and accuracy were superior for FNB vs FNA(84.70%vs 74.53%;99.29%vs 96.62%;and 87.62%vs 81.55%,respectively;P0.05).Multivariate analysis showed no significant predictor for better accuracy.On subgroup analyses,FNB was superior to FNA for non-pancreatic lesions;however,there was no difference between the techniques among pancreatic lesions.One adverse event was reported in each group.CONCLUSION FNB is superior to FNA with equivalent diagnostic test characteristics compared to FNA+ROSE in the diagnosis of non-pancreatic solid lesions.Our results suggest that EUS-FNB may eliminate the need of ROSE and should be employed as a first-line method in the diagnosis of solid lesions.

关键词： Endoscopic ultrasound-guided tissue acquisition Fine needle aspiration Fine needle biopsy solid lesions Endoscopic ultrasound Cancer

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