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A prospective, randomized, multicenter clinical trial comparing 25-gauge and 20-gauge biopsy needles for endoscopic ultrasound-guided sampling of solid pancreatic lesions

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Abstract

Background

Various core biopsy needles have previously been developed for endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB). However, the properties of needle gauge in the diagnostic outcomes of solid pancreatic lesions remain unknown. This trial compared the procurement rates of histologic cores from solid pancreatic lesions with EUS-FNB using 20- and 25-gauge (G) FNB needles.

Methods

In a prospective randomized multicenter clinical trial, patients with solid pancreatic lesions underwent EUS-FNB with either a 20-gauge or a 25-gauge FNB needle. The rates of histologic core procurement, overall diagnostic accuracy, and adverse events were compared between the two groups (20-gauge or 25-gauge FNB needle).

Results

In total, 88 patients (48 men, 40 women, mean age 65.7 years) were enrolled. No significant differences were found in the demographic characteristics between the two groups (20-gauge or 25-gauge FNB needle). The procurement rate of histologic cores in the 20-guage FNB needle group (41/45, 91.1%) was significantly higher than that in the 25-guage FNB needle group (32/43, 74.4%, P = 0.037). However, no significant differences were found in the overall diagnostic accuracy between 20-guage FNB needle (40/45, 88.9%) and 25-guage FNB needle (34/43, 79.1%, P = 0.208). No procedure-related adverse events were observed in either group.

Conclusions

Although both FNB needles provided high overall diagnostic accuracy, the reliability of the 20-guage FNB needle is better than the 25-guage FNB needle when retrieving samples for histological analysis.

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References

  1. Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA: Cancer J Clin 68:7–30

    Google Scholar 

  2. Hidalgo M (2010) Pancreatic cancer. N Engl J Med 362:1605–1617

    Article  CAS  Google Scholar 

  3. Rahib L, Smith BD, Aizenberg R, Rosenzweig AB, Fleshman JM, Matrisian LM (2014) Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Can Res 74:2913–2921

    Article  CAS  Google Scholar 

  4. Ooi M, Phan A, Nguyen NQ (2017) Future role of endoscopic ultrasound in personalized management of pancreatic cancer. Endosc Ultrasound 6:300–307

    Article  Google Scholar 

  5. Austin MC, Smith C, Pritchard CC, Tait JF (2016) DNA yield from tissue samples in surgical pathology and minimum tissue requirements for molecular testing. Arch Pathol Lab Med 140:130–133

    Article  Google Scholar 

  6. Ngamruengphong S, Li F, Zhou Y, Chak A, Cooper GS, Das A (2010) EUS and survival in patients with pancreatic cancer: a population-based study. Gastrointestinal Endosc 72:78–83

    Article  Google Scholar 

  7. Othman MO, Wallace MB (2012) The role of endoscopic ultrasonography in the diagnosis and management of pancreatic cancer. Gastroenterol Clin North Am 41:179–188

    Article  Google Scholar 

  8. Li H, Li W, Zhou QY, Fan B (2018) Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: a meta-analysis of randomized controlled trials. Medicine 97:e0207

    Article  Google Scholar 

  9. Nakai Y, Isayama H, Chang KJ, Yamamoto N, Hamada T, Uchino R, Mizuno S, Miyabayashi K, Yamamoto K, Kawakubo K, Kogure H, Sasaki T, Hirano K, Tanaka M, Tada M, Fukayama M, Koike K (2014) Slow pull versus suction in endoscopic ultrasound-guided fine-needle aspiration of pancreatic solid masses. Dig Dis Sci 59:1578–1585

    Article  Google Scholar 

  10. Ramesh J, Bang JY, Hebert-Magee S, Trevino J, Eltoum I, Frost A, Hasan MK, Logue A, Hawes R, Varadarajulu S (2015) Randomized trial comparing the flexible 19G and 25G needles for endoscopic ultrasound-guided fine needle aspiration of solid pancreatic mass lesions. Pancreas 44:128–133

    Article  Google Scholar 

  11. Bang JY, Hebert-Magee S, Trevino J, Ramesh J, Varadarajulu S (2012) Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions. Gastrointest Endosc 76:321–327

    Article  Google Scholar 

  12. Dumonceau JM, Deprez PH, Jenssen C, Iglesias-Garcia J, Larghi A, Vanbiervliet G, Aithal GP, Arcidiacono PG, Bastos P, Carrara S, Czako L, Fernandez-Esparrach G, Fockens P, Gines A, Havre RF, Hassan C, Vilmann P, van Hooft JE, Polkowski M (2017) Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline—Updated January 2017. Endoscopy 49:695–714

    Article  Google Scholar 

  13. Committee AT, Hwang JH, Aslanian HR, Thosani N, Goodman A, Manfredi M, Navaneethan U, Pannala R, Parsi MA, Smith ZL, Sullivan SA, Banerjee S, Maple JT (2017) Devices for use with EUS. VideoGIE: an official video journal of the American Society for Gastrointestinal Endoscopy 2:35–45

    Article  Google Scholar 

  14. Iglesias-Garcia J, Poley JW, Larghi A, Giovannini M, Petrone MC, Abdulkader I, Monges G, Costamagna G, Arcidiacono P, Biermann K, Rindi G, Bories E, Dogloni C, Bruno M, Dominguez-Munoz JE (2011) Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc 73:1189–1196

    Article  Google Scholar 

  15. Park SW, Chung MJ, Lee SH, Lee HS, Lee HJ, Park JY, Park SW, Song SY, Kim H, Chung JB, Bang S (2016) Prospective Study for Comparison of Endoscopic Ultrasound-Guided Tissue Acquisition Using 25- and 22-Gauge Core Biopsy Needles in Solid Pancreatic Masses. PLoS ONE 11:e0154401

    Article  Google Scholar 

  16. Iwashita T, Nakai Y, Samarasena JB, Park DH, Zhang Z, Gu M, Lee JG, Chang KJ (2013) High single-pass diagnostic yield of a new 25-gauge core biopsy needle for EUS-guided FNA biopsy in solid pancreatic lesions. Gastrointest Endosc 77:909–915

    Article  Google Scholar 

  17. Larghi A, Iglesias-Garcia J, Poley JW, Monges G, Petrone MC, Rindi G, Abdulkader I, Arcidiacono PG, Costamagna G, Biermann K, Bories E, Doglioni C, Dominguez-Munoz JE, Hassan C, Bruno M, Giovannini M (2013) Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: a multicenter prospective cohort study. Surg Endosc 27:3733–3738

    Article  Google Scholar 

  18. Nishioka N, Ogura T, Kurisu Y, Imanishi M, Onda S, Takagi W, Sano T, Okuda A, Miyano A, Amano M, Higuchi K (2018) Prospective histological evaluation of a 20G core trap with a forward-cutting bevel needle for EUS-FNA of pancreatic lesions. Surg Endosc 32:4125–4131

    Article  Google Scholar 

  19. Antonini F, Delconte G, Fuccio L, De Nucci G, Fabbri C, Armellini E, Frazzoni L, Fornelli A, Magarotto A, Mandelli E, Occhipinti P, Masci E, Manes G, Macarri G (2018) EUS-guided tissue sampling with a 20-gauge core biopsy needle for the characterization of gastrointestinal subepithelial lesions: a multicenter study. Endosc Ultrasound 8:105

    Article  Google Scholar 

  20. Khan MA, Grimm IS, Ali B, Nollan R, Tombazzi C, Ismail MK, Baron TH (2017) A meta-analysis of endoscopic ultrasound-fine-needle aspiration compared to endoscopic ultrasound-fine-needle biopsy: diagnostic yield and the value of onsite cytopathological assessment. Endosc Int Open 5:E363–E375

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea

    Eunae Cho & Chang-Hwan Park

  2. Department of Internal Medicine, Wonkwang University College of Medicine, Iksan, Republic of Korea

    Tae Hyeon Kim

  3. Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Chang-Min Cho

  4. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

    Dong Wan Seo

  5. Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea

    Jaihwan Kim

  6. Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea

    Jun Ho Choi

  7. Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea

    Sung-Hoon Moon

Authors
  1. Eunae Cho
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  2. Chang-Hwan Park
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  3. Tae Hyeon Kim
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  4. Chang-Min Cho
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  5. Dong Wan Seo
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  6. Jaihwan Kim
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  7. Jun Ho Choi
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Contributions

THK and CHP contributed to the conception and design of this study; CMC, DWS, JK, JHC, and SHM contributed to data acquisition; EC contributed to the data analysis, interpretation, and drafting the article; CHP contributed to editing the manuscript; and all authors were involved in revising and approving the final version for publication.

Corresponding authors

Correspondence to Chang-Hwan Park or Tae Hyeon Kim.

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Disclosures

Drs. Eunae Cho, Chang-Hwan Park, Tae Hyeon Kim, Chang-Min Cho, Dong Wan Seo, Jaihwan Kim, Jun Ho Choi, and Sung-Hoon Moon have no conflicts of interest or financial ties to disclose.

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Cho, E., Park, CH., Kim, T.H. et al. A prospective, randomized, multicenter clinical trial comparing 25-gauge and 20-gauge biopsy needles for endoscopic ultrasound-guided sampling of solid pancreatic lesions. Surg Endosc 34, 1310–1317 (2020). https://doi.org/10.1007/s00464-019-06903-x

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  • DOI: https://doi.org/10.1007/s00464-019-06903-x

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