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. 2024 Nov-Dec;13(6):351-360.
doi: 10.1097/eus.0000000000000095. Epub 2024 Dec 17.

EUS-guided fine-needle biopsy versus fine-needle aspiration for histopathological evidence for type 1 autoimmune pancreatitis: A single-center retrospective study in China

Yuyan Zhou  1 , Liqi Sun  1 , Xinyue Wang  1 , Dongling Wan  1 , Jiaheng Xu  1 , Mengruo Jiang  1 , Yue Liu  1 , Chao Liu  1 , Yatao Tu  1 , Haojie Huang  1 , Zhendong Jin  1
Affiliations

EUS-guided fine-needle biopsy versus fine-needle aspiration for histopathological evidence for type 1 autoimmune pancreatitis: A single-center retrospective study in China

Yuyan Zhou et al. Endosc Ultrasound. 2024 Nov-Dec.

Abstract

Background and objectives: EUS is recommended for guiding pancreatic tissue acquisition in suspected autoimmune pancreatitis (AIP) cases. However, there is a lack of comparative research on the effectiveness between EUS-guided fine-needle aspiration (EUS-FNA) and EUS-guided fine-needle biopsy (EUS-FNB) for diagnosing AIP in China. This study aimed to evaluate the diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) specifically for type 1 AIP.

Methods: Between 2010 and 2023, individuals with AIP who received EUS-TA at Changhai Hospital were included in the study.

Results: A total of 173 patients diagnosed with AIP who underwent EUS-TA were included in the final analysis. Of these, 104 patients (60.1%) received EUS-FNA, and 69 patients (39.9%) underwent EUS-FNB. Sufficient pancreatic tissue samples (>5 cells/high-power field) were obtained in 164 of 173 patients (94.8%), with success rates of 94.2% for EUS-FNA and 95.7% for EUS-FNB (P > 0.05). EUS-FNB exhibited higher rates of reliable level 1 histopathological findings (40.9% vs. 16.3%, P < 0.001) and reliable level 2 histopathological findings (33.3% vs. 12.2%, P < 0.001) compared with EUS-FNA. Furthermore, a higher occurrence of IgG4-positive plasma cell infiltration (>10 cells/high-power field) was observed with EUS-FNB compared with EUS-FNA (74.2% vs. 27.9%, P < 0.001). The multivariate logistic analysis also revealed that EUS-FNA was less effective in obtaining reliable evidence compared with EUS-FNB, as evident in both level 2 (P = 0.002; odds ratio, 0.21; 95% confidence interval, 0.08-0.56) and level 1 (P = 0.001; odds ratio, 0.19; 95% confidence interval, 0.08-0.49) histopathological evidence.

Conclusions: EUS-FNB demonstrates higher rates of level 1 and level 2 histopathological findings, as well as more abundant IgG4-positive plasma cell infiltration, compared with EUS-FNA.

Keywords: EUS-guided fine-needle aspiration; EUS-guided fine-needle biopsy; EUS-guided tissue acquisition; Type 1 autoimmune pancreatitis.

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Conflict of interest statement

Zhendong Jin is an Associate Editor of the journal. The article was subjected to the standard procedures of the journal, with a review process independent of the editor and his research group. The authors declare that they have no financial conflict of interest with regard to the content of this report.

Figures

Figure 1
Figure 1
Study flowchart of enrollment of patients who underwent EUS-TA. EUS-TA: EUS-guided tissue acquisition; ICDC: International Consensus Diagnostic Criteria; EUS-FNA: EUS-guided fine-needle aspiration; EUS-FNB: EUS-guided fine-needle biopsy.
Figure 2
Figure 2
Multivariable logistic regression analysis of factors associated with suspected type 1 AIP. Control group: insufficient histological evidence. AIP: autoimmune pancreatitis; SD: standard deviation; EUS-FNA: ultrasound-guided fine-needle aspiration; EUS-FNB: EUS fine-needle biopsy; 19-G: 19-gauge; 22G: 22-gauge; 25G: 25-gauge.
Figure 3
Figure 3
Multivariable logistic regression analysis of factors associated with level 2 histopathological evidence for type 1 AIP. Control group: insufficient histological evidence. AIP: autoimmune pancreatitis; SD: standard deviation; EUS-FNA: ultrasound-guided fine-needle aspiration; EUS-FNB: EUS-guided fine-needle biopsy; 19G: 19-gauge; 22G: 22-gauge; 25G: 25-gauge.
Figure 4
Figure 4
Multivariable logistic regression analysis of factors associated with level 1 histopathological evidence for type 1 AIP. Control group: insufficient histological evidence. AIP: autoimmune pancreatitis; SD: standard deviation; EUS-FNA: ultrasound-guided fine-needle aspiration; EUS-FNB: EUS-guided fine-needle biopsy; 19G: 19-gauge; 22G: 22-gauge; 25G: 25-gauge.
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