Fine Needle Aspiration versus Fine Needle Biopsy of Biliopancreatic Lesions: Are They Really Opposing Techniques or Can They Be Complementary? Our Experience in a Large Cohort of Cases from a Single Institution

被引:2
作者
Nicola, Marta [1 ]
Onorati, Monica [1 ]
Albertoni, Milena Maria [1 ]
Bianchi, Chiara Luisa [1 ]
De Nucci, Germana [2 ]
Mandelli, Enzo Domenico [2 ]
Nicola, Lidia [3 ]
Di Nuovo, Franca [1 ]
机构
[1] ASST Rhodense, Pathol Unit, Garbagnate Milanese, Italy
[2] ASST Rhodense, Gastroenterol Unit, Garbagnate Milanese, Italy
[3] Univ Pavia, Dept Earth & Environm Sci, Pavia, Italy
关键词
Biliopancreatic neoplasms; Fine needle aspiration; Fine needle biopsy; FNA; CORE; DIAGNOSIS;
D O I
10.1159/000510755
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Introduction: Nowadays, endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA), and fine needle biopsy (FNB) are considered the best procedures for the diagnosis of biliopancreatic lesions. These methods represent a milestone since they proved to be both safe for the patient and useful to achieve diagnostic material useful to plan the best treatment strategy. Objective: Since in the literature, a debate between cytology and histology supporters is still ongoing and the trend is changing in favor of FNB, we would like to present our experience about the diagnostic yield of FNA and FNB. The aim of our study is to highlight FNA versus FNB diagnostic role of biliopancreatic lesions, highlight advantages, and drawbacks of these procedures, and our view on these 2 procedures and whether they should still be considered complementary or opposing techniques. Methods: We retrospectively reviewed our hospital series of 469 EUS diagnostics procedures of biliopancreatic lesions performed in 419 patients, between 2015 and 2019. Results: The overall adequacy rates of FNA and FNB were, respectively, 98.9 and 100%. Stratifying cases according to anatomic location of the mass (pancreas vs. biliary system), we detected 168 malignancies out of 349 pancreatic lesions (168/349; 48.1%), while biliary system cases positive for malignancy represented 33.8% (23/68 cases) (p value = 0.045, chi(2) test). As for concomitant FNB, our series displayed a high rate of diagnostic concordance (88.8%). Conclusions: Despite numerous data published, it is still unclear which is the most feasible method to use; therefore, we compared FNA, FNB, or their combination to understand the best applicable technique. Our experience confirmed that FNA is extremely efficient in the diagnosis of biliopancreatic lesions, especially in the hands of expert endoscopists and pathologists. Considering anatomic location, EUS-FNA is more accurate for mass-forming neoplasms in the pancreatic parenchyma rather than for lesions of the biliary system. Moreover, concomitant FNB usually confirmed the cytological diagnosis, allowing a deeper immunohistochemical characterization of the neoplasia. This proves that a "pure" cytology and "pure" histology approach should be looked differently since these are complementary techniques especially if we can obtain a cellblock from FNA.
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页码:40 / 47
页数:8
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共 29 条
  • [21] Role of endoscopic ultrasound-guided-fine needle aspiration biopsy in the diagnosis of lymphoma of the pancreas: A clinicopathological study of nine cases
    Sadaf, S.
    Loya, A.
    Akhtar, N.
    Yusuf, M. A.
    [J]. CYTOPATHOLOGY, 2017, 28 (06) : 536 - 541
  • [22] Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses
    Sakamoto, Hiroki
    Kitano, Masayuki
    Komaki, Takamitsu
    Noda, Kazu
    Chikugo, Takaaki
    Dote, Kensaku
    Takeyama, Yoshifumi
    Das, Kunal
    Yamao, Kenji
    Kudo, Masatoshi
    [J]. JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2009, 24 (03) : 384 - 390
  • [23] Evaluation of 22G fine-needle aspiration (FNA) versus fine-needle biopsy (FNB) for endoscopic ultrasound-guided sampling of pancreatic lesions: a prospective comparison study
    Tian, Li
    Tang, An-Liu
    Zhang, Lei
    Liu, Xiao-Wen
    Li, Jing-Bo
    Wang, Fen
    Shen, Shou-Rong
    Wang, Xiao-Yan
    [J]. SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2018, 32 (08): : 3533 - 3539
  • [24] Combined versus single use 20G fine-needle biopsy and 25G fine-needle aspiration for endoscopic ultrasound-guided tissue sampling of solid gastrointestinal lesions
    van Riet, Priscilla A.
    Arcidiacono, Paolo Giorgio
    Petrone, Mariachiara
    Nam Quoc Nguyen
    Kitano, Masayuki
    Chang, Kenneth
    Larghi, Alberto
    Iglesias-Garcia, Julio
    Giovannini, Marc
    van der Merwe, Schalk
    Santo, Erwin
    Baldaque-Silva, Francisco
    Bucobo, Juan Carlos
    Bruno, Marco J.
    Aslanian, Harry R.
    Cahen, Djuna L.
    Farrell, James
    [J]. ENDOSCOPY, 2020, 52 (01) : 37 - 44
  • [25] A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device
    van Riet, Priscilla A.
    Larghi, Alberto
    Attili, Fabia
    Rindi, Guido
    Nam Quoc Nguyen
    Ruszkiewicz, Andrew
    Kitano, Masayuki
    Chikugo, Takaaki
    Aslanian, Harry
    Farrell, James
    Robert, Marie
    Adeniran, Adebowale
    Van Der Merwe, Schalk
    Roskams, Tania
    Chang, Kenneth
    Lin, Fritz
    Lee, John G.
    Arcidiacono, Paolo Giorgio
    Petrone, Mariachiara
    Doglioni, Claudio
    Iglesias-Garcia, Julio
    Abdulkader, Ihab
    Giovannini, Marc
    Bories, Erwan
    Poizat, Flora
    Santo, Erwin
    Scapa, Erez
    Marmor, Silvia
    Bucobo, Juan Carlos
    Buscaglia, Jonathan M.
    Heimann, Alan
    Wu, Maoxin
    Baldaque-Silva, Francisco
    Moro, Carlos Fernandez
    Erler, Nicole S.
    Biermann, Katharina
    Poley, Jan-Werner
    Cahen, Djuna L.
    Bruno, Marco J.
    [J]. GASTROINTESTINAL ENDOSCOPY, 2019, 89 (02) : 329 - 339
  • [26] EUS-guided tissue acquisition: Do we need to shoot for a "core" to score?
    Wani, Sachin
    Shah, Raj J.
    [J]. GASTROINTESTINAL ENDOSCOPY, 2016, 84 (06) : 1047 - 1049
  • [27] WHO classification of tumours editorial board, 2019, BREAST TUM
  • [28] Evaluation of the SharkCore® needle for EUS-guided core biopsy of pancreatic neuroendocrine tumors
    Witt, Benjamin L.
    Factor, Rachel E.
    Chadwick, Barbara E.
    Caron, Justin
    Siddiqui, Ali A.
    Adler, Douglas G.
    [J]. ENDOSCOPIC ULTRASOUND, 2018, 7 (05) : 323 - 328
  • [29] Utility of core biopsy with concurrent ROSE FNA in the diagnosis of pancreatic tumor-does the biopsy add any diagnostic benefit?
    Yan, Lei
    Ikemura, Kenji
    Park, Ji-Weon
    [J]. DIAGNOSTIC CYTOPATHOLOGY, 2018, 46 (02) : 154 - 159