Evaluation of 22G fine-needle aspiration (FNA) versus fine-needle biopsy (FNB) for endoscopic ultrasound-guided sampling of pancreatic lesions: a prospective comparison study

Abstract

Background: To compare the diagnostic yield and safety of 22G endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in the diagnosis of pancreatic solid lesions.

Methods: Between April 2014 and September 2015, 36 patients with pancreatic solid lesions were included for endoscopic ultrasound test. Patients were randomly divided into two groups: EUS-FNA (n = 18) and EUS-FNB (n = 18). Each nidus was punctured three times (15 ~ 20 insertions for each puncture) with a 22G needle. The core specimens were analyzed, and the diagnostic yields of FNA and FNB were evaluated.

Results: The procedure success rate was 100% with no complications. Cytological and histological examinations found that the diagnostic yield of FNB and FNA were both 83.3%. To get a definitive diagnosis, FNB needed fewer punctures than FNA (1.11 vs. 1.83; P < 0.05).

Conclusions: 22G EUS-FNB is a safe and effective way to diagnose pancreatic solid lesions. FNB required a lower number of needle passes to achieve a diagnosis compared with FNA.

Keywords: Pancreatic solid lesion; Ultrasound-guided fine-needle aspiration; Ultrasound-guided fine-needle biopsy.

Fig. 1

EUS-guided biopsy from pancreatic solid masses using FNA (A) and FNB (B)

Fig. 2

Tissue core obtained using the 22G fine-needle biopsy needle by EUS-FNA (A) and FNB (B)

Fig. 3

Histological evaluation of specimens obtained (hematoxylin & eosin [H&E] staining). A pancreatic ductal adenocarcinoma, sample obtained using the new 22G fine-needle biopsy needle by EUS-FNA. B pancreatic ductal adenocarcinoma, sample obtained using standard fine-needle aspiration needle by EUS-FNB