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Is the new procore 20g double forward-bevel needle capable to obtain better histological samples by endoscopic ultrasound for diagnosing solid pancreatic lesions? / A nova agulha procore 20g com bisel frontal duplo é capaz de obter melhores amostras histológicas por ecoendoscopia no diagnóstico de lesões sólidas pancreáticas?
Ardengh, José Celso; Brunaldi, Vitor Ottoboni; Brunaldi, Mariângela Ottoboni; Gaspar, Alberto Facuri; Lopes-Júnior, Jorge Resende; Sankarankutty, Ajith Kumar; Kemp, Rafael; Santos, José Sebastião dos.
  • Ardengh, José Celso; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Brunaldi, Vitor Ottoboni; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Brunaldi, Mariângela Ottoboni; University of São Paulo. Ribeirão Preto Medical School. Hospital das Clínicas. São Paulo. BR
  • Gaspar, Alberto Facuri; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Lopes-Júnior, Jorge Resende; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Sankarankutty, Ajith Kumar; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Kemp, Rafael; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
  • Santos, José Sebastião dos; University of São Paulo. Ribeirão Preto Medical School. Department of Surgery and Anatomy. São Paulo. BR
ABCD (São Paulo, Impr.) ; 33(4): e1554, 2020. tab, graf
Article in English | LILACS | ID: biblio-1152626
ABSTRACT
ABSTRACT

Background:

It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined.

Aim:

To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy.

Methods:

This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist.

Results:

The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively.

Conclusions:

The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.
RESUMO
RESUMO Racional As lesões sólidas pancreáticas não ressecáveis cirurgicamente demandam boa amostragem tecidual para definição histológica e condução oncológica . O papel das novas agulhas de ecopunção no aprimoramento diagnóstico ainda necessita elucidação.

Objetivo:

Comparar as biópsias guiadas por ecoendoscoopia com a nova agulha 20G de bisel frontal duplo (FNB) com a agulha de aspiração fina 22G convencional.

Métodos:

Este estudo prospectivo avaliou 20 pacientes submetidos à punção de lesões pancreáticas sólidas com ambas agulhas e envolveu análise de amostras teciduais por um único patologista.

Resultados:

A agulha FNB 20G forneceu amostras de tecido mais adequadas (16 vs. 9, p=0,039) com melhores escores quantitativos de celularidade (11 vs. 5, p=0,002) e maior diâmetro máximo da amostra histológica (1,51±1,3 mm vs. 0,94±0,55 mm, p=0,032) que a agulha 22G. O sucesso técnico, dificuldade de punção e sangramento da amostra foram semelhantes entre os grupos. A sensibilidade, especificidade e acurácia diagnóstica foram 88,9%, 100% e 90% e 77,8%, 100% e 78,9% para as agulhas 20G e 22G, respectivamente.

Conclusão:

As amostras obtidas com a FNB 20G apresentaram melhores parâmetros histológicos, embora não tenha havido diferença no desempenho diagnóstico entre as duas agulhas.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Pancreas / Pancreatic Neoplasms / Endoscopic Ultrasound-Guided Fine Needle Aspiration / Needles Type of study: Controlled clinical trial / Diagnostic study / Observational study Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: ABCD (São Paulo, Impr.) Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Pancreas / Pancreatic Neoplasms / Endoscopic Ultrasound-Guided Fine Needle Aspiration / Needles Type of study: Controlled clinical trial / Diagnostic study / Observational study Limits: Adolescent / Adult / Aged / Aged80 / Female / Humans / Male Language: English Journal: ABCD (São Paulo, Impr.) Year: 2020 Type: Article Affiliation country: Brazil Institution/Affiliation country: University of São Paulo/BR