Comparison of endoscopic ultrasound guided 22-gauge core needle with standard 25-gauge fine-needle aspiration for diagnosing solid pancreatic lesions.
Author(s): Berzosa M, Villa N, El-Serag HB, Sejpal DV, Patel KK
Publication: Endosc Ultrasound, 2015, Vol. 4, Page 28-33
PubMed ID: 25789281 PubMed Review Paper? No
Purpose of Paper
The purpose of this paper was to compare the percentage of informative specimens as well as the sensitivity and specificity of 25-gauge fine needle aspiration (25G FNA) and 19-gauge core needle biopsy (19G CNB) specimens.
Conclusion of Paper
A comparable proportion of 25G FNA and 19G CNB specimens contained adequate cellularity for diagnosis. The overall sensitivity and specificity of 25G FNA for malignancies were 68.1% and 100%, respectively, and the sensitivity and specificity of 19 G CNB for malignancies were 59.6% and 100%, respectively.
Studies
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Study Purpose
The purpose of this study was to compare the percentage of specimens with sufficient cellularity for diagnosis as well as the sensitivity and specificity of 25G FNA and 19G CNB specimens. Sixty-one solid pancreatic lesions from 56 patients were procured by endoscopic ultrasound (EUS)-guided FNA and EUS-guided CNB during a single endoscopic procedure. Specimens were obtained from three to five passes for each method. Diagnosis was confirmed by surgical resection or clinical follow-up combined with imaging. The method of FNA and CNB preservation was not specified by the authors, but although it is assumed that FNA specimens were preserved by alcohol and surgical specimens were formalin fixed.
Summary of Findings:
A comparable proportion of FNA and CNB specimens contained adequate cellularity (81.9% versus 73.8%, respectively, P=0.37). Of the 47 cases adequate for diagnosis by FNA or CNB, diagnosis was obtained only by FNA in 4 cases and only by CNB in 1 case. Diagnosis of malignant lesions was possible in 80% of cases based on FNA and 70% of cases based on CNB. However, malignancies were missed by both FNA and CNB in 8 cases based on their identification 6 months after the initial biopsies, resulting in overall sensitivity of 68.1% and 59.6% for FNA and CNB specimens, respectively, with an increase of 1.5% if both FNA and CNB were used. The specificity of FNA and CNB was 100%.
Biospecimens
Preservative Types
- Ethanol
- Formalin
Diagnoses:
- Neoplastic - Carcinoma
- Neoplastic - Benign
- Neoplastic - Other
Platform:
Analyte Technology Platform Morphology Light microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Needle gauge 22-gauge
25-gauge
Biospecimen Acquisition Method of tissue acquisition Fine needle aspiration
Core needle biopsy
Surgical resection