Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer

  • Tadayuki Takagi (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Mitsuru Sugimoto (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Hidemichi Imamura (Department of Gastroenterology, Ohtanishinouchi Hospital) ;
  • Yosuke Takahata (Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University) ;
  • Yuki Nakajima (Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University) ;
  • Rei Suzuki (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Naoki Konno (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Hiroyuki Asama (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Yuki Sato (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Hiroki Irie (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Jun Nakamura (Department of Endoscopy, Fukushima Medical University Hospital) ;
  • Mika Takasumi (Department of Gastroenterology, School of Medicine, Fukushima Medical University) ;
  • Minami Hashimoto (Department of Endoscopy, Fukushima Medical University Hospital) ;
  • Tsunetaka Kato (Department of Endoscopy, Fukushima Medical University Hospital) ;
  • Ryoichiro Kobashi (Department of Endoscopy, Fukushima Medical University Hospital) ;
  • Yuko Hashimoto (Department of Diagnostic Pathology, School of Medicine, Fukushima Medical University) ;
  • Goro Shibukawa (Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University) ;
  • Shigeru Marubashi (Department of Hepato-Biliary-Pancreatic and Transplant Surgery, School of Medicine, Fukushima Medical University) ;
  • Takuto Hikichi (Department of Endoscopy, Fukushima Medical University Hospital) ;
  • Hiromasa Ohira (Department of Gastroenterology, School of Medicine, Fukushima Medical University)
  • Received : 2021.12.01
  • Accepted : 2022.02.22
  • Published : 2023.01.30
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Abstract

Background/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods: A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018-2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results: No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions: EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

Keywords

Acknowledgement

We thank all the staff at the Department of Gastroenterology of Fukushima Medical University (Ohtanishinouchi Hospital and Aizu Medical Center), the Department of Endoscopy of Fukushima Medical University Hospital, and the gastroenterology ward of the Fukushima Medical University Hospital.

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