Tu1650 Feasibility and Diagnostic Yield of a New EUS Guided Histology 20-Gauge Needle in the Evaluation of Intraintestinal and Extraintestinal Lesions

Autor: Marco J. Bruno, Geneviève Monges, Guido Costamagna, Alberto Larghi, Jan-Werner Poley, Guido Rindi, Ihab Abdulkader, Enrique Dominguez-Munoz, Emanuele Dabizzi, Erwan Bories, Maria Chiara Petrone, Julio Iglesias-Garcia, Claudio Doglioni, Marc Giovannini, Paolo Giorgio Arcidiacono, Jose Lariño-Noia, Priscilla A. van Riet, Katharina Biermann
Přispěvatelé: Julio, Iglesias-Garcia, Priscilla, A Van Riet, Alberto, Larghi, Marc, Giovannini, Maria, C Petrone, Jose, Lariño-Noia, Jan-Werner, Poley, Erwan, Borie, Emanuele, Dabizzi, Ihab, Abdulkader, Genevieve, M Monge, Katharina, Biermann, Guido, Rindi, Claudio, Doglioni, Guido, Costamagna, Arcidiacono, P. G., Marco, J Bruno, Enrique, Dominguez-Munoz
Rok vydání: 2015
Předmět:
Zdroj: Gastrointestinal Endoscopy. 81:AB545
ISSN: 0016-5107
DOI: 10.1016/j.gie.2015.03.1102
Popis: Tu1649 Comparison of EUS-Guided Tissue Acquisition Using 25-Gauge and 22-Gauge Core Biopsy Needles Through Needle Cross-Over: a Prospective, Randomized Study Se Woo Park*, Moon Jae Chung, Jeong Youp Park, Seung Woo Park, SI Young Song, Seungmin Bang Department of Internal Medicine, Institute of Gastroenterology, Hallym University College of Medicine, Hallym University Dongtan Sacred Heart Hospital, Gyeonggi-do, Korea (the Republic of); Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea (the Republic of) Backgrounds: Even though theoretically thicker needle is able to get more tissue, hardness of the needle can lead to mechanical damage to endoscope, technical failure or potential blood contamination of sample. It is uncertain if needle gauge impacts the diagnostic outcomes of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) of pancreatic mass lesions. Aim The aim of this study was to evaluate 25G core biopsy needles in procurement rate of histologic core compared with 22G needles through EUS-FNB of pancreatic mass. Methods: From March 2014 to July 2014, 56 patients with solid pancreatic mass underwent EUS-FNB with both 25G and 22G core biopsy needle. Needle sequence was selected randomly, and two passes were made with each needle, consisting of 20 uniform to-and-fro movements on each pass with 10-ml syringe suction. A pathologist blinded to sequence of needle evaluated specimens for presence of the histologic core. Results: The mean age of the patients was 65.8 9.5 (range, 44-89) and 35 patients (62.5%) were male. The mean size of pancreatic masses was 35.3 17.1 mm (range 14-122.3 mm). Twenty eight patients (50%) had tumor at head/uncinate process of pancreas. There was no significant difference in procurement rate (for 25G 49/56 [87.5%] and for 22G 46/56 [82.1%], PZ0.599) and diagnostic accuracy (for 25G 98%, for 22G 95%). There were no technical failures or procedure related adverse events. Conclusion: Our study results confirm a trend towards a better procurement of histologic core and diagnostic accuracy for the 25-gauge needle though the difference was not significant. Furthermore, in a particular anatomic site, the 25-gauge needle could be recommended because it has a diagnostic accuracy similar to that of the 22-gauge needle but has fewer technical difficulties. Tu1650 Feasibility and Diagnostic Yield of a New EUS Guided Histology 20-Gauge Needle in the Evaluation of Intraintestinal and Extraintestinal Lesions Julio Iglesias-Garcia*, Priscilla A. Van Riet, Alberto Larghi, Marc Giovannini, Maria C. Petrone, Jose Larino-Noia, Jan-Werner Poley, Erwan Bories, Emanuele Dabizzi, Ihab Abdulkader, Genevieve M. Monges, Katharina Biermann, Guido Rindi, Claudio Doglioni, Guido Costamagna, Paolo G. Arcidiacono, Marco J. Bruno, Enrique Dominguez-Munoz Gastroenterology, University Hospital. Foundation for research in digestive diseases, Santiago de Compostela, Spain; Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, Netherlands; Digestive Endoscopy Unit, Catholic University, Rome, Italy; Endoscopic Unit, Paoli-Calmettes institut, Marseilles, France; Gastroenterology and Gastrointestinal Endoscopy Unit, Vita Salute San Raffaele University, Milan, Italy; Pathology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain; Foundation for research in digestive diseases, Santiago de Compostela, Spain; Pathology, Paoli-Calmettes institut, Marseilles, France; Pathology, Erasmus MC, University Medical Center, Rotterdam, Netherlands; Pathology, Vita Salute San Raffaele University, Milan, Italy; Pathology, Catholic University, Rome, Italy Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is an accurate technique for sampling intraintestinal and extraintestinal lesions. However, cytology possesses certain limitations, which may be overcome if histological specimens are provided to the pathologist. The aim of the study was to evaluate the feasibility and accuracy of a newly developed 20-gauge histology needle. Methods: Retrospective analysis of a prospectively collected data base including patients who underwent EUS-guided biopsy with the 20-gauge ProCore histology needle with reverse bevel (3-HD-20) for the evaluation of intraintestinal or extraintestinal lesions. EUS procedures were performed under sedation with linear echoendoscopes (Olympus and Pentax). Samples recovered into cytological solution or formalin and processed for histological evaluation. Results were compared to the gold standard of surgical histopathology, or global pathological, clinical and radiological assessment, and follow-up in non-operated cases. Feasibility of the procedure and different technical aspects were recorded. Percentage of samples suitable for histological evaluation and the overall diagnostic accuracy were evaluated. Results are shown as mean and standard deviation or 95% confidence interval. Results: 51 patients (mean age 62.2 years, range 36-83 years, 26 male) were included. A total of 52 lesions were attempted to be sampled (mean size 31.88 12.4mm). Indications were pancreatic www.giejournal.org Vol mass (nZ30), intraabdominal lymph nodes (LN) (nZ6), subepithelial lesions (nZ6), liver mass (nZ3) and 1 cases of mediastinal LN, lung cancer, rectal mass, esophageal lesion, hiliar mass, intraabdominal mass and a left suprarenal gland mass. Lesions were accessed from esophagus in 3 cases, stomach in 27 cases, bulbous in 15 cases, second part of the duodenum in 6 cases and from the rectum in 1 case. EUS-guided biopsy was feasible in 50 cases (96.1%), with a mean of 1.7 passes (range 1-4). From 50 cases completed, sample quality was adequate for histological assessment in 46 lesions (92.0%). In the intention to treat analysis, diagnostic yield was 84.6% (95%CI: 72.5-91.9) and in per protocol analysis, diagnostic yield was 88.0% (95%CI 76.2-94.4). There were 2 (3.9%) mild complications (intraparietal hematomas at the place of FNB). Conclusion: The EUS-guided biopsy with the 20gauge Procore histology needle provides with a very good core sample for histological evaluation allowing a high histopathologic diagnostic accuracy. Tu1651 Diagnosis of Autoimmune Pancreatitis Using Endoscopic Ultrasound Guided Pancreatic Core Biopsy With Procore Needle Dongwook Oh*, Sang Soo Lee, Jin-Seok Park, Tae Young Park, Tae Jun Song, Do Hyun Park, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea (the Republic of) Objective: Histologic diagnosis is important for the diagnosis of autoimmune pancreatitis (AIP). Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) has been performed to establish histologic diagnosis. To evaluate the usefulness of EUS-FNB using 19-gauge ProCore needles for the diagnosis of AIP. Methods: EUSFNB with 19-gauge ProCore needle was performed in 15 patients who were suspected with AIP between July 2012 and July 2014. These patients were classified based on the international consensus diagnostic criteria (ICDC). Results: The amount of obtained tissue samples was enough for histologic diagnosis. 15 patients were classified into type 1 AIP (nZ14; definite nZ10, probable nZ4), type 2 AIP (nZ1, definite). Based on the ICDC, 5 and 6 of 15 patients have level 1 (positive for 3 or 4 items) and level 2 (positive for 2 items) histological findings. 7 of 15 patients showed typical diffuse swelling on parenchymal imaging. Among them, 4 and 3 of 8 patients were positive for level 1 and level 2 histologic findings. 8 of 15 patients showed atypical imaging (low-density mass, segmental enlargement with delayed enhacement) on parenchymal imaging. Among these patients, 2 and 3 of 8 patients were positive for level 1 and level 2 histologic findings. There was no adverse events after procedure. Conclusions: EUS-FNB by using 19-gauge ProCore needle is a safe and useful for histologic diagnosis of AIP. Clinical findings of 15 patients ume 81, No. 5S : 2015 GASTROINTESTINAL ENDOSC Total (n[15)
Databáze: OpenAIRE