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Endoscopy 2014; 46(12): 1056-1062
DOI: 10.1055/s-0034-1377558
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study

Yun Nah Lee
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Jong Ho Moon
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Hee Kyung Kim
2   Department of Pathology, SoonChunHyang University School of Medicine, Bucheon, Korea
,
Hyun Jong Choi
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Moon Han Choi
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Dong Choon Kim
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Tae Hoon Lee
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Sang-Woo Cha
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Young Deok Cho
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
,
Sang-Heum Park
1   Digestive Disease Center and Research Institute, Department of Internal Medicine, SoonChunHyang University School of Medicine, Bucheon and Seoul, Korea
› Author Affiliations
Further Information

Publication History

submitted: 01 October 2013

accepted after revision: 12 May 2014

Publication Date:
06 August 2014 (online)

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See also:

Commentaire du travail de Lee YN et al., pp. 1056Endoscopy 2014; 46(12): 1128-1128
DOI: 10.1055/s-0034-1391141

See also:

Commentaire du travail de Vanbiervliet G. et al., pp. 1063Endoscopy 2014; 46(12): 1129-1129
DOI: 10.1055/s-0034-1391142

Background and study aims: An endoscopic ultrasound (EUS)-guided fine needle biopsy (EUS-FNB) device using a core biopsy needle was developed to improve diagnostic accuracy by simultaneously obtaining cytological aspirates and histological core samples. We prospectively compared the diagnostic accuracy of EUS-FNB with standard EUS-guided fine needle aspiration (EUS-FNA) in patients with solid pancreatic masses.

Patients and methods: Between January 2012 and May 2013, consecutive patients with solid pancreatic masses were prospectively enrolled and randomized to undergo EUS-FNB using a core biopsy needle or EUS-FNA using a standard aspiration needle at a single tertiary center. The specimen was analyzed by onsite cytology, Papanicolaou-stain cytology, and histology. The main outcome measure was diagnostic accuracy for malignancy. The secondary outcome measures were: the median number of passes required to establish a diagnosis, the proportion of patients in whom the diagnosis was established with each pass, and complication rates.

Results: The overall accuracy of combining onsite cytology with Papanicolaou-stain cytology and histology was not significantly different for the FNB (n = 58) and FNA (n = 58) groups (98.3 % [95 %CI 94.9 % – 100 %] vs. 94.8 % [95 %CI 91.9 % – 100 %]; P = 0.671). Compared with FNA, FNB required a significantly lower median number of needle passes to establish a diagnosis (1.0 vs. 2.0; P < 0.001). On subgroup analysis of 111 patients with malignant lesions, the proportion of patients in whom malignancy was diagnosed on the first pass was significantly greater in the FNB group (72.7 % vs. 37.5 %; P < 0.001).

Conclusions: The overall accuracy of FNB and FNA in patients with solid pancreatic masses was comparable; however, fewer passes were required to establish the diagnosis of malignancy using FNB.

This study was registered on the UMIN Clinical Trial Registry (UMIN000014057).

 

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