Fine-needle biopsy is superior to fine-needle aspiration of suspected gastrointestinal stromal tumors: a large multicenter study

Arvind J. Trindade; Petros C. Benias; Mohammed Alshelleh; Ahmad N. Bazarbashi; Benjamin Tharian; Sumant Inamdar; Neil Sharma; Christina Zelt; Praneet Korrapati; Mohamed Barakat; Divyesh V. Sejpal; Marvin Ryou

doi:10.1055/a-0953-1640

Endoscopy International Open, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(07): E931-E936
DOI: 10.1055/a-0953-1640

Original article

Fine-needle biopsy is superior to fine-needle aspiration of suspected gastrointestinal stromal tumors: a large multicenter study

Autoren

Arvind J. Trindade

¹Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York, United States
Petros C. Benias

¹Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York, United States

²Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, United States
Mohammed Alshelleh

¹Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York, United States
Ahmad N. Bazarbashi

³Division of Gastroenterology, Brigham and Women’s Hospital, Boston, MA
Benjamin Tharian

⁴Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Sumant Inamdar

⁴Division of Gastroenterology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States
Neil Sharma

⁵Parkview Health System, Wayne, Indiana, United States
Christina Zelt

⁵Parkview Health System, Wayne, Indiana, United States
Praneet Korrapati

²Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, United States
Mohamed Barakat

²Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York, United States
Divyesh V. Sejpal

¹Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, New York, United States
Marvin Ryou

³Division of Gastroenterology, Brigham and Women’s Hospital, Boston, MA

Abstract

Background and study aims There are numerous studies published on the diagnostic yield of the new fine-needle biopsy (FNB) needles in pancreas masses. However, there are limited studies in suspected gastrointestinal stromal tumors (GIST lesions). The aim of this study was to evaluate the diagnostic yield of a new fork-tip FNB needle.

Patients and methods This was a multicenter retrospective study of consecutive patients from prospectively maintained databases comparing endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus endoscopic ultrasound-guided FNB (EUS-FNB) using the fork-tip needle. Outcomes measured were cytopathology yield (ability to obtain tissue for analysis of cytology), ability to analyze the tissue for immunohistochemistry (IHC yield), and diagnostic yield (ability to provide a definitive diagnosis).

Results A total of 147 patients were included in the study of which 101 underwent EUS-FNB and 46 patients underwent EUS-FNA. Median lesion size in each group was similar (21 mm vs 25 mm, P = 0.25). Cytopathology yield, IHC yield, and diagnostic yield were 92 % vs 46 % (P = 0.001), 89 % vs 41 % (P = 0.001), and 89 % vs 37 % (P = 0.001) between the FNB and FNA groups, respectively. Median number of passes was the same between the two groups at 3.5.

Conclusion EUS-FNB is superior to EUS-FNA for diagnostic yield of suspected GIST lesions. This should be confirmed with a prospective study.

Volltext

Referenzen

References
1 Hedenbro JL, Ekelund M, Wetterberg P. Endoscopic diagnosis of submucosal gastric lesions. The results after routine endoscopy. Surg Endosc 1991; 5: 20-23
2 Polkowski M, Gerke W, Jarosz D. et al. Diagnostic yield and safety of endoscopic ultrasound-guided trucut [corrected] biopsy in patients with gastric submucosal tumors: a prospective study. Endoscopy 2009; 41: 329-334
3 Obuch J, Wani S. EUS-guided tissue acquisition in GI stromal tumors. Gastrointest Endosc 2017; 86: 516-518
4 Nishida T, Blay J-Y, Hirota S. et al. The standard diagnosis, treatment, and follow-up of gastrointestinal stromal tumors based on guidelines. Gastric Cancer 2016; 19: 3-14
5 Akahoshi K. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol 2007; 13: 2077
6 Hoda KM, Rodriguez SA, Faigel DO. EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc 2009; 69: 1218-1223
7 Philipper M, Hollerbach S, Gabbert H. et al. Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors. Endoscopy 2010; 42: 300-305
8 Watson RR, Binmoeller KF, Hamerski CM. et al. Yield and performance characteristics of endoscopic ultrasound-guided fine needle aspiration for diagnosing upper GI tract stromal tumors. Dig Dis Sci 2011; 56: 1757-1762
9 El Chafic AH, Loren D, Siddiqui A. et al. Comparison of FNA and fine-needle biopsy for EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc 2017; 86: 510-515
10 Fernández-Esparrach G, Sendino O, Solé M. et al. Endoscopic ultrasound-guided fine-needle aspiration and trucut biopsy in the diagnosis of gastric stromal tumors: a randomized crossover study. Endoscopy 2010; 42: 292-299
11 Kim GH, Cho YK, Kim EY. Korean EUS Study Group. et al. Comparison of 22-gauge aspiration needle with 22-gauge biopsy needle in endoscopic ultrasonography-guided subepithelial tumor sampling. Scand J Gastroenterol 2014; 49: 347-354
12 Jovani M, Abidi WM, Lee LS. Novel fork-tip needles versus standard needles for EUS-guided tissue acquisition from solid masses of the upper GI tract: a matched cohort study. Scand J Gastroenterol 2017; 52: 784-787
13 Bang JY, Hebert-Magee S, Navaneethan U. et al. Randomized trial comparing the Franseen and Fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions. Gastrointest Endosc 2018; 87: 1432-1438
14 Kandel P, Tranesh G, Nassar A. et al. EUS-guided fine needle biopsy sampling using a novel fork-tip needle: a case-control study. Gastrointest Endosc 2016; 84: 1034-1039
15 Abdelfatah MM, Grimm IS, Gangarosa LM. et al. Cohort study comparing the diagnostic yields of 2 different EUS fine-needle biopsy needles. Gastrointest Endosc 2018; 87: 495-500
16 Naveed M, Siddiqui AA, Kowalski TE. et al. A multicenter comparative trial of a novel EUS-guided core biopsy needle (SharkCoreTM) with the 22-gauge needle in patients with solid pancreatic mass lesions. Endosc Ultrasound 2018; 7: 34-40
17 Ishikawa T, Mohamed R, Heitman SJ. et al. Diagnostic yield of small histological cores obtained with a new EUS-guided fine needle biopsy system. Surg Endosc 2017; 31: 5143-5149
18 Kim GH, Park DY, Kim S. et al. Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?. 2009; 15: 3376-3381
19 Nagula S, Pourmand K, Aslanian H. et al. New York Endoscopic Research Outcomes Group (NYERO). Comparison of endoscopic ultrasound-fine-needle aspiration and endoscopic ultrasound-fine-needle biopsy for solid lesions in a multicenter, randomized trial. Clin Gastroenterol Hepatol 2018; 16: 1307-1313
20 Machicado JD, Wani S, Thosani N. Will Abandoning fine-needle aspiration increase diagnostic yield from tissues collected during endoscopic ultrasound?. Clin Gastroenterol Hepatol 2018; 16: 1203-1206
21 Wani S, Shah RJ. EUS-guided tissue acquisition: Do we need to shoot for a “core” to score?. Gastrointest Endosc 2016; 84: 1047-1049
22 Bengt HM, Akif N. High clinical impact and diagnostic accuracy of EUS-guided biopsy sampling of subepithelial lesions : a prospective, comparative study. 2018; 21: 1304-1313