Clinical Endoscopy

  • 제55권5호
  • /
  • Pages.637-644
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  • 2022
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  • 2234-2400(pISSN)
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  • 2234-2443(eISSN)
대한소화기내시경학회 (The Korean Society of Gastrointestinal Endoscopy)
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Comparison of diagnostic performances of slow-pull suction and standard suction in endoscopic ultrasound-guided fine needle biopsy for gastrointestinal subepithelial tumors

  • Joon Seop Lee (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Chang Min Cho (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • Yong Hwan Kwon (Department of Internal Medicine, Kyungpook National University School of Medicine) ;
  • An Na Seo (Department of Pathology, Kyungpook National University School of Medicine) ;
  • Han Ik Bae (Department of Pathology, Kyungpook National University School of Medicine) ;
  • Man-Hoon Han (Department of Pathology, Kyungpook National University School of Medicine)
  • 투고 : 2021.10.13
  • 심사 : 2021.12.30
  • 발행 : 2022.09.30
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초록

Background/Aims: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is integral to the diagnosis of gastrointestinal (GI) subepithelial tumors (SETs). The impact of different EUS-FNB tissue sampling techniques on specimen adequacy and diagnostic accuracy in SETs has not been fully evaluated. This study aimed to compare the diagnostic outcomes of slow-pull (SP) and standard suction (SS) in patients with GI SETs. Methods: In this retrospective comparative study, 54 patients were enrolled. Medical records were reviewed for location and size of the target lesion, FNB needle type/size, technical order, specimen adequacy, diagnostic yield, and adverse events. The acquisition rate of adequate specimens and diagnostic accuracy were compared according to EUS-FNB techniques. Results: The mean lesion size was 42.6±36.4 mm, and most patients were diagnosed with GI stromal tumor (75.9%). The overall diagnostic accuracies of the SP and SS techniques were 83.3% and 81.5%, respectively (p=0.800). The rates of obtaining adequate core tissue were 79.6% and 75.9%, respectively (p=0.799). No significant clinical factors affected the rate of obtaining adequate core tissue, including lesion location and size, FNB needle size, and final diagnosis. Conclusions: SP and SS had comparable diagnostic accuracies and adequate core tissue acquisition for GI SETs via EUS-FNB.

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참고문헌

  1. Dumonceau JM, Deprez PH, Jenssen C, et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline-updated January 2017. Endoscopy 2017;49:695-714. https://doi.org/10.1055/s-0043-109021
  2. Polkowski M. Endoscopic ultrasound and endoscopic ultrasound-guided fine-needle biopsy for the diagnosis of malignant submucosal tumors. Endoscopy 2005;37:635-645. https://doi.org/10.1055/s-2005-861422
  3. Karaca C, Turner BG, Cizginer S, et al. Accuracy of EUS in the evaluation of small gastric subepithelial lesions. Gastrointest Endosc 2010;71:722-727. https://doi.org/10.1016/j.gie.2009.10.019
  4. Rosch T, Kapfer B, Will U, et al. Endoscopic ultrasonography. Accuracy of endoscopic ultrasonography in upper gastrointestinal submucosal lesions: a prospective multicenter study. Scand J Gastroenterol 2002;37:856-862. https://doi.org/10.1080/gas.37.7.856.862
  5. Lee JH, Choi KD, Kim MY, et al. Clinical impact of EUS-guided Trucut biopsy results on decision making for patients with gastric subepithelial tumors ≥2 cm in diameter. Gastrointest Endosc 2011;74:1010-1018. https://doi.org/10.1016/j.gie.2011.06.027
  6. Mekky MA, Yamao K, Sawaki A, et al. Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors. Gastrointest Endosc 2010;71:913-919. https://doi.org/10.1016/j.gie.2009.11.044
  7. Philipper M, Hollerbach S, Gabbert HE, et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy 2010;42:300-305. https://doi.org/10.1055/s-0029-1244006
  8. Polkowski M, Bergman JJ. Endoscopic ultrasonography-guided biopsy for submucosal tumors: needless needling? Endoscopy 2010;42:324-326. https://doi.org/10.1055/s-0029-1244070
  9. Akahoshi K, Sumida Y, Matsui N, et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol 2007;13:2077-2082. https://doi.org/10.3748/wjg.v13.i14.2077
  10. Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc 2009;69:1218-1223. https://doi.org/10.1016/j.gie.2008.09.045
  11. Yoshida S, Yamashita K, Yokozawa M, et al. Diagnostic findings of ultrasound-guided fine-needle aspiration cytology for gastrointestinal stromal tumors: proposal of a combined cytology with newly defined features and histology diagnosis. Pathol Int 2009;59:712-719. https://doi.org/10.1111/j.1440-1827.2009.02433.x
  12. Fernandez-Esparrach G, Sendino O, Sole M, et al. Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy 2010;42:292-299. https://doi.org/10.1055/s-0029-1244074
  13. Polkowski M, Gerke W, Jarosz D, et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy 2009;41:329-334. https://doi.org/10.1055/s-0029-1214447
  14. de Moura DT, McCarty TR, Jirapinyo P, et al. EUS-guided fine-needle biopsy sampling versus FNA in the diagnosis of subepithelial lesions: a large multicenter study. Gastrointest Endosc 2020;92:108-119. https://doi.org/10.1016/j.gie.2020.02.021
  15. Facciorusso A, Sunny SP, Del Prete V, et al. Comparison between fine-needle biopsy and fine-needle aspiration for EUS-guided sampling of subepithelial lesions: a meta-analysis. Gastrointest Endosc 2020;91:14-22. https://doi.org/10.1016/j.gie.2019.07.018
  16. Affolter KE, Schmidt RL, Matynia AP, et al. Needle size has only a limited effect on outcomes in EUS-guided fine needle aspiration: a systematic review and meta-analysis. Dig Dis Sci 2013;58:1026-1034. https://doi.org/10.1007/s10620-012-2439-2
  17. Pih GY, Kim DH. Endoscopic ultrasound-guided fine needle aspiration and biopsy in gastrointestinal subepithelial tumors. Clin Endosc 2019;52:314-320. https://doi.org/10.5946/ce.2019.100
  18. Tadic M, Stoos-Veic T, Kusec R. Endoscopic ultrasound guided fine needle aspiration and useful ancillary methods. World J Gastroenterol 2014;20:14292-14300. https://doi.org/10.3748/wjg.v20.i39.14292
  19. Varadarajulu S, Fockens P, Hawes RH. Best practices in endoscopic ultrasound-guided fine-needle aspiration. Clin Gastroenterol Hepatol 2012;10:697-703. https://doi.org/10.1016/j.cgh.2012.03.017
  20. Iwashita T, Nakai Y, Samarasena JB, et al. High single-pass diagnostic yield of a new 25-gauge core biopsy needle for EUS-guided FNA biopsy in solid pancreatic lesions. Gastrointest Endosc 2013;77:909-915. https://doi.org/10.1016/j.gie.2013.01.001
  21. Matsubayashi H, Matsui T, Yabuuchi Y, et al. Endoscopic ultrasonography guided-fine needle aspiration for the diagnosis of solid pancreaticobiliary lesions: clinical aspects to improve the diagnosis. World J Gastroenterol 2016;22:628-640. https://doi.org/10.3748/wjg.v22.i2.628
  22. Fabbri C, Polifemo AM, Luigiano C, et al. Endoscopic ultrasound-guided fine needle aspiration with 22- and 25-gauge needles in solid pancreatic masses: a prospective comparative study with randomisation of needle sequence. Dig Liver Dis 2011;43:647-652. https://doi.org/10.1016/j.dld.2011.04.005
  23. Nakai Y, Isayama H, Chang KJ, et al. Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses. Dig Dis Sci 2014;59:1578-1585. https://doi.org/10.1007/s10620-013-3019-9
  24. Crino SF, Le Grazie M, Manfrin E, et al. Randomized trial comparing fork-tip and side-fenestrated needles for EUS-guided fine-needle biopsy of solid pancreatic lesions. Gastrointest Endosc 2020;92:648-658. https://doi.org/10.1016/j.gie.2020.05.016
  25. Crino SF, Manfrin E, Scarpa A, et al. EUS-FNB with or without onsite evaluation for the diagnosis of solid pancreatic lesions (FROSENOR): protocol for a multicenter randomized non-inferiority trial. Dig Liver Dis 2019;51:901-906. https://doi.org/10.1016/j.dld.2019.03.008
  26. Zhang XC, Li QL, Yu YF, et al. Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis. Surg Endosc 2016;30:2431-2441. https://doi.org/10.1007/s00464-015-4494-1
  27. Paik WH, Park Y, Park DH, et al. Prospective evaluation of new 22 gauge endoscopic ultrasound core needle using capillary sampling with stylet slow-pull technique for intra-abdominal solid masses. J Clin Gastroenterol 2015;49:199-205. https://doi.org/10.1097/MCG.0000000000000084
  28. Antonini F, Delconte G, Fuccio L, et al. EUS-guided tissue sampling with a 20-gauge core biopsy needle for the characterization of gastrointestinal subepithelial lesions: a multicenter study. Endosc Ultrasound 2019;8:105-110. https://doi.org/10.4103/eus.eus_1_18
  29. Kim DH, Kim GH, Cho CM, et al. Feasibility of a 20-gauge ProCore needle in EUS-guided subepithelial tumor sampling: a prospective multicenter study. BMC Gastroenterol 2018;18:151.
  30. Bang JY, Hebert-Magee S, Hasan MK, et al. Endoscopic ultrasonography-guided biopsy using a Franseen needle design: initial assessment. Dig Endosc 2017;29:338-346. https://doi.org/10.1111/den.12769
  31. Schlag C, Menzel C, Gotzberger M, et al. Endoscopic ultrasound-guided tissue sampling of small subepithelial tumors of the upper gastrointestinal tract with a 22-gauge core biopsy needle. Endosc Int Open 2017;5:E165-E171. https://doi.org/10.1055/s-0042-119948
  32. Yi M, Xia L, Zhou Y, et al. Prognostic value of tumor necrosis in gastrointestinal stromal tumor: a meta-analysis. Medicine (Baltimore) 2019;98:e15338.