Comparison of 21-gauge and 22-gauge aspiration needle during endobronchial ultrasound-guided transbronchial needle aspiration.
Author(s): Nakajima T, Yasufuku K, Takahashi R, Shingyoji M, Hirata T, Itami M, Matsui Y, Itakura M, Iizasa T, Kimura H
Publication: Respirology, 2011, Vol. 16, Page 90-4
PubMed ID: 20920141 PubMed Review Paper? No
Purpose of Paper
This paper compared diagnosis rates and histological structure in matched 21-gauge (G) and 22-G endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).
Conclusion of Paper
Although specificity and histological preservation were comparable, EBUS-TBNA biopsies obtained with a 21-G needle generally contained more tumor cells and blood contamination than those obtained with 22-G biopsies. Further, 21-G biopsies had a slightly higher sensitivity than 22-G biopsies (100% versus 91.3%), but demonstrated a trend of decreased preservation of non-necrotizing granulomatous inflammation suggestive of sarcoidosis.
Studies
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Study Purpose
This study compared diagnosis rates and histological structure in matched 21G and 22-G EBUS-TBNA. EBUS-TBNA were obtained from 33 patients (45 lesions) by one surgeon, first using a 22-G needle and then a 21-G needle. During each pass, the needle was moved back and forth 10-15 times and passes were conducted until a core was available with a maximum of three passes. Cytological analysis was performed on the smears and histological analysis was conducted on the formalin-fixed core. When necessary for diagnosis, immunohistochemistry (IHC) was performed on formalin-fixed specimens but the antibodies used were not specified.
Summary of Findings:
The number of adequate cells was greater in smears from 21-G than 22-G needles in 49.9% of biopsies (22 of 45) and fewer in only 24.4% of biopsies (11 of 45, P=0.0256); however, blood contamination was higher in 73.3% and lower in 6.7% of 22-G than 21-G biopsies (P=0.0001). The histological preservation was superior to the other needle gauge in a comparable number of 21-G and 22-G biopsies. Further, the specificity of 21-G and 22-G needle biopsies was comparable (100%) but the sensitivity was slightly higher for 21-G than 22-G biopsies (100% versus 91.3%). Finally, there was a trend toward better preservation of non-necrotizing granulomatous inflammation suggestive of sarcoidosis in the 22-G than 21-G biopsies (62.5% better and 25% worse, P=0.0695).
Biospecimens
Preservative Types
- Other Preservative
- Formalin
Diagnoses:
- Neoplastic - Benign
- Other diagnoses
- Neoplastic - Lymphoma
- Neoplastic - Carcinoma
Platform:
Analyte Technology Platform Morphology Light microscopy Morphology H-and-E microscopy Pre-analytical Factors:
Classification Pre-analytical Factor Value(s) Biospecimen Acquisition Needle gauge 21-G
22-G