22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic masses: a randomized study comparing histologic sample quantity and diagnostic accuracy

David Karsenti; Laurent Palazzo; Bastien Perrot; Jacqueline Zago; Anne-Isabelle Lemaistre; Jérôme Cros; Bertrand Napoléon

doi:10.1055/a-1160-5485

Endoscopy, Inhaltsverzeichnis

Endoscopy 2020; 52(09): 747-753
DOI: 10.1055/a-1160-5485

Original article

22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic masses: a randomized study comparing histologic sample quantity and diagnostic accuracy

David Karsenti

¹Digestive Endoscopy Unit, Pôle Digestif Paris Bercy, Clinique de Paris-Bercy, Charenton-le-Pont, France

,

Laurent Palazzo

²Digestive Endoscopy Unit, Clinique du Trocadéro, Paris, France

,

Bastien Perrot

³UMR1246_SPHERE Methods for Patient-Centered Outcomes and Health Research, Nantes University, France

,

Jacqueline Zago

⁴Pathology Department, 29 rue du Colisée, Paris, France

,

Anne-Isabelle Lemaistre

⁵Department of Pathology, Eurofins Biomnis, Lyon, France

,

Jérôme Cros

⁶Beaujon Hospital, Pathology Department, Université de Paris, INSERM U1149, Clichy, France

,

Bertrand Napoléon

⁷Digestive Endoscopy Unit, Hôpital Privé Jean Mermoz, Ramsay Générale de Santé, Lyon, France

› Institutsangaben

Abstract

Background Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has been suggested for obtaining high quality tissue samples from pancreatic tumors. We performed a multicenter randomized crossover trial comparing EUS-FNB with a 20G Procore needle vs. a 22G Acquire needle. The aims were to compare the quantity of targeted tissue (pancreas) and diagnostic accuracy for the two needles.

Methods 60 patients admitted for EUS-FNB in three endoscopy units were included. One pass was performed consecutively with each needle, in a randomized order. Histologic material was studied in a blinded manner with respect to the needle. The primary end point was mean cumulative length of tissue core biopsies per needle pass.

Results Final diagnosis was adenocarcinoma (n = 46; 77 %), neuroendocrine neoplasm (n = 11; 18 %), autoimmune pancreatitis (n = 2), and mass-forming chronic pancreatitis (n = 1). The mean cumulative length of tissue core biopsies per needle pass was significantly higher with the 22G Acquire needle at 11.4 mm (95 % confidence interval [CI] 9.0 – 13.8] vs. 5.4 mm (95 %CI 3.8 – 7.0) for the 20G Procore needle (P < 0.001), as was the mean surface area (3.5 mm² [95 %CI 2.7 – 4.3] vs. 1.8 mm²[95 %CI 1.2 – 2.3]; P < 0.001). Diagnostic adequacy and accuracy were 100 % and 87 % with the 22G Acquire needle, and 82 % and 67 % with the 20G Procore needle (P = 0.001 and P = 0.02, respectively).

Conclusions EUS-guided biopsy of pancreatic masses with the 22G Acquire needle provided more tissue for histologic evaluation and better diagnostic accuracy than the 20G Procore needle.

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Referenzen

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