STANDARD VERSUS CORE NEEDLE IN EUS-GUIDED SAMPLING OF PANCREATIC ADENOCARCINOMA: A SINGLE-CENTER EXPERIENCE

Aims Fine needle biopsy (FNB) using core needles has been increasingly used in the last years, as an alternative to standard fine needle aspiration (FNA) for procurement of better tissue samples. We aimed to compare the diagnostic adequacy and diagnostic yield for pancreatic adenocarcinoma using standard versus core needle, in a center without in-site cytopathology.

Methods All patients with a diagnosis of pancreatic adenocarcinoma admitted in our clinic over a period of 18 months were enrolled. Endoscopic ultrasound (EUS) was performed using a Pentax-Hitachi linear probe and tissue sampling was done using either standard EchoTip needle or ProCore needle (Cook Medical). Final diagnosis was set by FNA/FNB, repeated FNA/FNB, surgery or long- term outcome. Diagnostic adequacy of samples and the diagnostic yield for malignancy was compared between the two groups – FNA versus FNB needle.

Results Altogether 64 patients were enrolled, median age 62.9 years, 62.5% males. FNB using the core needle was done in 23/58 (35.9%) of patients, while the other 64.1% were punctured using FNA needle. Mean tumor size was 33.8 mm in the FNA group, and 33.9 mm in the FNB group. More pancreatic head tumors were sampled using an FNA needle – 53.7% versus 43.5%. Also, more 22 G needles were used in the FNA group (48.8% vs. 30%). Diagnostic adequacy was achieved in 90.2% of FNA samples and 95% of FNB. Diagnostic yield for malignancy was slightly better for FNB – 91.3%, compared to FNA – 80.5%.

Conclusions In our study cohort, both needles had good diagnostic performance for pancreatic adenocarcinoma, but the core one proved to be slightly better.