Background and Aims
EUS-guided fine needle biopsy (FNB) sampling and FNA are important methods for obtaining
core tissues and cytologic aspirates. To improve the specimen quality for pathologic
evaluation, a novel EUS-FNB Shark Core (SC) needle has been designed to acquire core
tissue during EUS procedures. We compared the histology yield of EUS-FNB sampling
using the SC needle (EUS-FNB-SC) to EUS-FNA in patients who had solid pancreatic and
nonpancreatic lesions.
Methods
This was a retrospective case-control study design. Between July 2012 and July 2015
all patients who had EUS-FNB-SC and EUS-FNA were reviewed through a hospital EUS database.
Consecutive samples from EUS-FNB-SCs were matched in a 1:3 ratio by lesion site (eg,
pancreatic head) and needle gauge (ie, 19 gauge, 22 gauge, 25 gauge) to recent random
samples of EUS-FNA. The procedures were performed with rapid onsite evaluation. For
study purposes specimen slides were evaluated by 2 cytopathologists for histologic
yield using a standard scoring system (0 = no material, 1-2 = cytologic, 3-5 = histologic).
The main objectives were to assess the histologic yield of the samples and compare
the median number of passes required to obtain core tissue by using EUS-FNB-SC and
EUS-FNA needles.
Results
Of the 156 patients included in study, 25% patients (n = 39) were in the EUS-FNB-SC
group and 75% (n = 117) in the EUS-FNA group. According to standard scoring criteria
for histology, the median histology score for EUS-FNA was 2 (sufficient for cytology
but not histology) and for EUS-FNB-SC was 4 (sufficient for adequate histology). Ninety-five
percent of the specimens obtained from the EUS-FNB-SC group were of sufficient size
for histologic screening, compared with 59% from the EUS-FNA group (P = .01). The median number of passes required to achieve a sample was significantly
lower in the EUS-FNB-SC group compared with the EUS-FNA group (2 passes vs 4 passes,
P = .001). There was significant difference in the median number of passes to all lesion
sites and needle gauges.
Conclusions
The histology yield was significantly higher using the EUS-FNB-SC needle compared
with the EUS-FNA needle. Additionally, fewer passes were required to obtain histology
cores when using EUS-FNB-SC.
Abbreviations:
EUS-FNA (EUS-guided FNA), EUS-FNB (EUS-guided fine needle biopsy), EUS-TNB (EUS-guided Tru-Cut needle biopsy), EUS-FNB-SC (EUS-guided fine needle biopsy sampling using the Shark Core needle), ROSE (rapid onsite cytologic evaluation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 23, 2016
Accepted:
March 16,
2016
Received:
January 6,
2016
Footnotes
DISCLOSURE: The following author disclosed financial relationships relevant to this publication: M. B. Wallace: Consultant for Olympus Corp.; grant support from Boston Scientific and Cosmo Pharmaceuticals. All other authors disclosed no financial relationships relevant to this publication.
Identification
Copyright
Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
