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ORIGINAL RESEARCH article

Front. Med.
Sec. Pathology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1422600
This article is part of the Research Topic Advances in Therapeutic Gastrointestinal Endoscopy: from Bench to Bedside View all 6 articles

Comparing Needle Types And Aspiration Techniques In EUS-TA To Optimize Diagnostic Efficacy And Specimen Quality In Patients With Pancreatic Lesions

Provisionally accepted
Shang Ru min Shang Ru min 1Xiangming Han Xiangming Han 2He Fang Wei He Fang Wei 3*Lv Fei Lv Fei 3*Zeng Cui Zeng Cui 3*Chen Kun Chen Kun 3*Huang Li Hua Huang Li Hua 4*Ding Xiang Wu Ding Xiang Wu 3*
  • 1 Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
  • 2 Nanjing Drum Tower Hospital, Nanjing, Jiangsu Province, China
  • 3 Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
  • 4 Department of Oncology, Wuhan Fourth Hospital, Wuhan, Hubei Province, China

The final, formatted version of the article will be published soon.

    Purpose: In solid pancreatic lesions (SPLs), we compared the diagnostic efficacy of a 19G fine-needle aspiration (FNA) needle and a 22G ProCore fine-needle biopsy (FNB) needle, We also compared the specimen quality between the standard suction (SS) technique and heparinized wet-suction (HWS) technique. Methods:All cases of endoscopic ultrasound-guided tissue acquisition (EUS-TA) by 19G FNA or 22G FNB for SPLs in a single-centre hospital were retrospectively reviewed. The diagnostic yield was compared between the 19G and 22G groups. Univariate and multivariate logistic regression analyses were used to identify optimal factors for a correct histological diagnosis.We also examined tissue integrity, the length of the tissue cores, and the rate of blood cell contamination between the SS and HWS groups. Results: 171 and 63 patients were included in the comparisons of needle types and suction techniques, respectively. The 19G group had higher histological diagnosis rates compared to the 22G group for the first pass (87.8% vs 70.4%, P = 0.005), the second pass (82.2% vs 65.4%, P = 0.012), the first two passes (90.0% vs 72.8%, P = 0.004), and the final diagnosis (91.1% vs 79%, P = 0.025). Through macroscopic on-site evaluation , a significantly higher proportion of patients in the 22G group required a third needle pass compared to the 19G group (88.9% vs 67.8%, P = 0.002). The total procedure time was shorter in the 19G group than in the 22G group (P < 0.001). The HWS group showed superiority over the SS group in terms of the total length of tissue cores (P < 0.001) and the total length of white tissue cores (P = 0.005). The HWS group, compared to the SS group, can enhance the tissue integrity (P=0.024) and reduce blood cell contamination (P = 0.040) during the first needle pass. There was no significant difference in complication rates between the needle puncture groups (P=0.770) or the aspiration technique groups (P=0.654). Conclusion: Compared to the 22G FNB needle, endoscopists should consider using the 19G FNA needle when appropriate. Furthermore, the use of the HWS technique for the first pass is recommended to improve specimen quality.

    Keywords: Endoscopic ultrasound-guided tissue acquisition, biopsy needle, Suction technique, Heparin, diagnosis, Histological integrity, Blood cell contamination

    Received: 08 May 2024; Accepted: 12 Nov 2024.

    Copyright: © 2024 min, Han, Wei, Fei, Cui, Kun, Hua and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    He Fang Wei, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
    Lv Fei, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
    Zeng Cui, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
    Chen Kun, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China
    Huang Li Hua, Department of Oncology, Wuhan Fourth Hospital, Wuhan, Hubei Province, China
    Ding Xiang Wu, Department of Gastroenterology, Wuhan Fourth Hospital, Wuhan, Hebei Province, China

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