Comparison of the novel Franseen needle versus the fine-needle aspiration needle in endoscopic ultrasound-guided tissue acquisition for cancer gene panel testing: A propensity score-matching analysis

Abstract

Background and aim: Reports have indicated that a surface area of 4 mm² or more of collected tissue sections could provide the recommended total DNA for the OncoGuide NCC Oncopanel system, which is a cancer gene panel test developed in Japan. We wished to compare the percentage of tissue sections collected by endoscopic ultrasound-assisted tissue acquisition (EUS-TA) with surface areas of ≥4 mm² between a conventional needle, namely the EZ Shot 3 Plus (Olympus Medical Japan, Tokyo, Japan) (EZ3), and the recent SonoTip TopGain (MediGlobe, Rohrdorf, Germany) (TopGain).

Method: From April 2010 to December 2021, among 693 EUS-TA cases, EZ3 was used in 390 cases and TopGain in 45. The EZ3 and TopGain groups were matched in a 1:1 ratio with a tolerance of 0.2, with 35 patients each matched using propensity score analysis.

Results: The TopGain group had a significantly higher percentage of cases with a tissue area of ≥4 mm² than the EZ3 group (42.9% vs 68.6%, P = 0.030). Multivariate analysis revealed an association between TopGain and tissue areas of ≥4 mm² (odds ratio 2.996, 95% confidence interval 1.068-8.403, P = 0.037).

Conclusions: EUS-TA using TopGain significantly collected more ≥4 mm² tissue area compared with EZ3, suggesting its usefulness for cancer gene panel testing.

Keywords: endoscopic ultrasound‐guided fine‐needle aspiration; endoscopy; fine‐needle biopsy; neoplasms; oncogenes.

Figure 1

We used EZ3 in 390 cases, TopGain in 45 cases, and other needles in 273 cases out of 693 EUS‐TA cases performed at our institution from April 2010 to December 2021. EZ3 and TopGain were matched 1:1 with a tolerance of 0.2. Propensity score‐matching was performed using explanatory variables such as age, sex, clinical diagnosis of tumor, lesion site, puncture route, and needle diameter, with 35 cases matched. EUS‐TA, endoscopic ultrasound‐guided tissue acquisition; EZ3, EZ Shot 3 Plus (Olympus Medical Systems, Tokyo, Japan); TopGain, SonoTip TopGain (MediGlobe, Rohrdorf, Germany).

Figure 2

Tissue area collected by endoscopic ultrasound‐guided tissue acquisition with EZ3 and TopGain. EZ3, EZ Shot 3 Plus (Olympus Medical Systems, Tokyo, Japan); TopGain, SonoTip TopGain (MediGlobe); NS, not significant (P >0.05).

Figure 3

The proportion of cases in which the tissue area sampled by endoscopic ultrasound‐guided tissue acquisition was ≥4 mm². EZ3, EZ Shot 3 Plus (Olympus Medical Systems, Tokyo, Japan); TopGain, SonoTip TopGain (MediGlobe).

Figure 4

(a) Tumor cellularity and (b) percentage of tumor cellularity ≥20% of specimens obtained by EUS‐TA in pancreatic cancer patients using EZ3 and TopGain. EZ3, EZ Shot 3 Plus (Olympus Medical Systems, Tokyo, Japan); TopGain, SonoTip TopGain (MediGlobe); NS, not significant (P >0.05).