Evaluation of endoscopic ultrasound-guided fine-needle biopsy for preoperative pancreatic solid lesions

Abstract

Objectives

Obtaining an accurate preoperative diagnosis is crucial. This study aimed to evaluate the diagnostic accuracy and utility of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) for preoperative pancreatic solid lesions.

Materials and methods

We retrospectively assessed all patients who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB to evaluate solid pancreatic lesions preoperatively at our center between July 2013 and June 2020. We enrolled 71 patients who underwent EUS-FNA using a 22 G conventional needle (FNA group) and 34 patients who underwent EUS-FNB using a 22 G Franseen needle (FNB group). Overall, 105 patients were analyzed. We employed propensity-matched analysis and adjusted the confounders.

Results

No procedural adverse events were encountered. Both groups showed no significant differences in the procedure time, technical success rate, and rate of operator changes from trainee to expert. Regarding diagnostic accuracy, the FNB group (88.2%; 30/34) was higher but not significantly different from the FNA group (85.3%; 29/34) (p > .99). Furthermore, the FNB group (median 2, IQR;2–3) had a significantly lower number of punctures than the FNA group (median 3, IQR; 2–4) (p = .01).

Conclusions

The FNB needle provides higher diagnostic accuracy and requires significantly fewer punctures than conventional needles even at facilities with no available rapid on-site evaluation. Thus, using the FNB needle can be useful for preoperative pancreatic solid lesions.

Keywords:

• Endoscopic ultrasound
• endoscopic ultrasound-guided fine-needle aspiration
• fine-needle biopsy
• Franseen needle
• histology

Author contributions

Fujita A and RyozawaS designed the report; Fujita A, TanisakaY, Ogawa T, Suzuki M, Katsuda H, Tashima T, and Mizuide M were attending physicians for the patients; Fujita A and Araki R contributed to the analysis and interpretation of data and assisted in manuscript preparation. Fujita A andRyozawa S organized the report; and Fujita A wrote the paper.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

The datasets used and analyzed in the current study are available from the corresponding author on reasonable request.