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. 2024 Sep 2;16(9):e68431.
doi: 10.7759/cureus.68431. eCollection 2024 Sep.

Evaluation of Needles in Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreatic Cancer for Genetic Yield and Quality

Jonathan Tiong  1 , Phi Nguyen  1 , Mithra Sritharan  1 , Joanne Lundy  2 , Henry Shen  1 , Beena Kumar  3 , Michael Swan  4 , Brendan Jenkins  2 , Daniel Croagh  1
Affiliations

Evaluation of Needles in Endoscopic Ultrasound-Guided Tissue Acquisition of Pancreatic Cancer for Genetic Yield and Quality

Jonathan Tiong et al. Cureus. .

Abstract

Background: Endoscopic ultrasound-guided fine needle biopsy (FNB) is the gold standard in tissue acquisition of pancreatic ductal adenocarcinoma (PDAC). There is a paucity of evidence of the impact of needle type or size on the genetic yield and quality.

Methods: Patients 18 years and older with PDAC who underwent FNB were retrospectively identified from a single database from 2016 to 2021. Genetic quantity is measured in micrograms (µg) and quality defined by RNA or DNA integrity number (RIN and DIN). FNB needles examined were Acquire 22 gauge (Boston Scientific, Marlborough, MA, USA) and ProCore 22 and 20 gauges (Cook Medical, Bloomington, IN, USA).

Results: Two hundred seventy-seven patients were identified. ProCore 20G needle procured higher RNA quantity (4125.8µg, IQR: 2003.8, 5954.8, p = 0.012) compared to ProCore 22G (2050µg IQR: 966.4, 3181.6) and Acquire 22G (2310.6µg, IQR: 1439.3, 4312). Median DNA quantity was 3340.5µg (Acquire 22G), 2610.4µg (ProCore 22G) and 3499.7µg (ProCore 20G) (p = 0.763). Median DIN was 7.3 (Acquire 22G and ProCore 22G) and 7.4 (ProCore 20G) (p = 0.449). Median RIN was 3.0 (Acquire 22G and ProCore 22G) and 2.7 (ProCore 20G) (p = 0.886).

Conclusion: ProCore 20G was associated with higher quantity of RNA. There were no differences in the quality acquired by different needles.

Keywords: endoscopic ultrasound guided needle biopsy; genetic yield; needle size; needle type; pancreatic cancer.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Monash Health issued approval 80025. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Data collection
VPCB=Victorian Pancreatic Cancer Bank; PDAC=Pancreatic ductal adenocarcinoma; DNA=Deoxyribonucleic acid; RNA=Ribonucleic acid
Figure 2
Figure 2. Kruskal Wallis test for RNA quantity
RNA=Ribonucleic acid
Figure 3
Figure 3. Pairwise comparison of NanoDrop against needles. Each node shows the sample average rank of needle type.
Figure 4
Figure 4. Kruskal Wallis test for DNA quantity
DNA=Deoxyribonucleic acid
Figure 5
Figure 5. Kruskal Wallis test for DNA quality
DNA=Deoxyribonucleic acid
Figure 6
Figure 6. Graph showing RNA and DNA each belonging to the same patient over time.
DNA=Deoxyribonucleic acid; RNA=Ribonucleic acid
Figure 7
Figure 7. DNA and RNA correlation.
DNA=Deoxyribonucleic acid; RNA=Ribonucleic acid
Figure 8
Figure 8. ProCore reverse bevel Westcott; Cook Medical
Figure 9
Figure 9. Acquire three-pronged “Franseen” style needle; Boston Scientific
Figure 10
Figure 10. ProCore 20G forward bevel; Cook Medical
See this image and copyright information in PMC

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