Endoscopic ultrasound through-the-needle biopsy of pancreatic cystic neoplasms: Update on indications, safety profile, and research directions

IF 5.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Best Practice & Research Clinical Gastroenterology Pub Date : 2026-03-01 Epub Date: 2025-10-28 DOI:10.1016/j.bpg.2025.102058

Joana Mota , Tiago Ribeiro , Maria Cristina Conti Bellocchi , Nicolò De Pretis , Luca Frulloni , Joanne Lopes , Sokol Sina , Jahnvi Dhar , Jayanta Samanta , Guilherme Macedo , Filipe Vilas-Boas , Stefano Francesco Crinò

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引用次数: 0

Abstract

Pancreatic cystic lesions (PCLs) are often benign; however, a subset carries malignant potential, making accurate diagnosis essential to avoid both missed malignancies and overtreatment. Conventional tools, such as cyst fluid cytology and biochemical analysis, have limited sensitivity, often leading to misdiagnosis.

This review summarizes the role of endoscopic ultrasound-guided through-the-needle biopsy (EUS-TTNB) for PCL diagnosis, incorporates recent ESGE recommendations, and discusses future directions.

EUS-TTNB enables direct histologic sampling of pancreatic cysts, improving tissue adequacy and diagnostic accuracy, while maintaining a low complication rate. Studies report diagnostic yields exceeding 80 % and strong concordance with surgical histology. The integration with next-generation sequencing may further enhance diagnostic precision and risk stratification.

In conclusion, EUS-TTNB is a valuable tool within current diagnostic pathways for PCLs. Its broader implementation may enhance clinical decision-making and ultimately improve patient outcomes. Nonetheless, multicenter studies and standardized protocols are still needed to validate its role in routine practice.

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胰腺囊性肿瘤的内镜超声穿刺活检：适应症、安全性和研究方向的最新进展

胰腺囊性病变（PCLs）通常是良性的；然而，一个亚群具有恶性潜能，因此准确的诊断对于避免遗漏的恶性肿瘤和过度治疗至关重要。传统的工具，如囊肿液细胞学和生化分析，灵敏度有限，经常导致误诊。本文综述了超声内镜引导下穿刺活检（EUS-TTNB）在PCL诊断中的作用，结合了最近的ESGE建议，并讨论了未来的发展方向。EUS-TTNB能够对胰腺囊肿进行直接组织学采样，提高组织充分性和诊断准确性，同时保持低并发症发生率。研究报告诊断率超过80%，与手术组织学高度一致。与新一代测序结合可进一步提高诊断精度和风险分层。总之，EUS-TTNB是当前pcl诊断途径中的一个有价值的工具。它的广泛实施可能会增强临床决策，并最终改善患者的治疗效果。尽管如此，仍需要多中心研究和标准化协议来验证其在常规实践中的作用。

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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来源期刊

Best Practice & Research Clinical Gastroenterology 医学-胃肠肝病学

CiteScore

5.50

自引率

0.00%

发文量

审稿时长

69 days

期刊介绍： Each topic-based issue of Best Practice & Research Clinical Gastroenterology will provide a comprehensive review of current clinical practice and thinking within the specialty of gastroenterology.