Endoscopic ultrasound–guided fine-needle biopsy as a novel approach for risk stratification of pancreatic cystic lesions

iGIE Pub Date : 2025-03-01 DOI:10.1016/j.igie.2025.01.009

Ghazal Hashemipour Moussavi BS , Maria F. Gomez MPH , Jennifer Permuth PhD , Aamir Dam MD , Anjuli K. Luthra MD , Luis Pena MD , Mark Friedman MD , Saraswathi Cappelle MD , Barbara Centeno MD , Shaffer R.S. Mok MD

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Abstract

Background and Aims

Unlike fine-needle biopsy (FNB), fine-needle aspiration (FNA) is limited by its inability to preserve histopathology. We compared the diagnostic yield of endoscopic ultrasound (EUS)–guided FNA and EUS-FNB for pancreatic cystic lesions (PCLs), hypothesizing that EUS-FNB would frequently provide a tissue diagnosis.

Methods

A single-center retrospective cohort study was conducted from 2022 to 2023 on patients with PCLs who underwent either EUS-FNA or EUS-FNB. We compared cyst characteristics and pathology reports to assess diagnostic yield. The relative risk (RR) was calculated to compare FNB’s probability of identifying intraductal papillary mucinous neoplasm (IPMN) grade compared with FNA.

Results

A total of 130 PCLs were identified (FNA: n = 34; FNB: n = 96). Patients had a mean age of 68 ± 12 years, and 49% were women. Sex, age, cyst size, location, and presence of pancreatic ductal dilation did not differ significantly between FNA and FNB groups. FNB showed a significantly higher diagnostic yield compared with FNA (81% vs 62%; P = .02), with better performance in identifying an IPMN grade compared with FNA (RR = 1.92; P = .013).

Conclusions

Our results reflect one of the first studies, to our knowledge, to consider the diagnostic role of FNB in evaluating PCLs. These preliminary results suggest that FNB may have a potential for high diagnostic performance in PCLs and warrant further exploration using a larger cohort and randomized controlled trials.

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超声内镜引导下细针活检作为胰腺囊性病变危险分层的新方法

背景和AimsUnlike细针活检（FNB），细针穿刺（FNA）是有限的，因为它不能保持组织病理学。我们比较了内镜超声（EUS）引导下的FNA和EUS- fnb对胰腺囊性病变（PCLs）的诊断率，假设EUS- fnb经常提供组织诊断。方法对2022 - 2023年接受EUS-FNA或EUS-FNB治疗的pcl患者进行单中心回顾性队列研究。我们比较囊肿的特征和病理报告来评估诊断率。计算相对危险度（RR），比较FNB与FNA鉴别导管内乳头状黏液性肿瘤（IPMN）分级的概率。结果共检出pcl 130株(FNA: n = 34；FNB: n = 96)。患者平均年龄为68±12岁，女性占49%。性别、年龄、囊肿大小、位置和胰管扩张的存在在FNA组和FNB组之间没有显著差异。FNB的诊断率明显高于FNA (81% vs 62%；P = .02)，与FNA相比，在识别IPMN分级方面表现更好(RR = 1.92；P = .013)。结论我们的结果反映了我们所知的第一个考虑FNB在评估pcl中的诊断作用的研究之一。这些初步结果表明，FNB可能在pcl诊断中具有很高的潜力，值得通过更大的队列和随机对照试验进行进一步的探索。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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