细针活检与细针穿刺在诊断免疫组化要求病变中的比较:一项前瞻性多中心研究

IF 4.4 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Yuchong Zhao, Dingkun Xiong, Aruna, Qian Chen, Dong Kuang, Si Xiong, Yun Wang, Yilei Yang, Qiaozhen Guo, Lan Chen, Jiqiao Zhang, Xiaoli Wu, Yunlu Feng, Bin Cheng
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引用次数: 0

摘要

目的 EUS引导下细针活检(EUS-FNB)优于细针穿刺(FNA)仍存在争议。本研究旨在比较 FNB 和 FNA 对免疫组化(IHC)要求病变的疗效,这些病变包括 1 型自身免疫性胰腺炎(AIP)、神经内分泌肿瘤(NET)、间质瘤和淋巴瘤。研究分析了人口统计学、IHC标本的充分性、诊断准确性和组织的完整性。结果 共纳入 439 例患者进行分析。大多数病变类型为 1 型 AIP(41.69%),其次是 NET、间质瘤和淋巴瘤。FNB 标本的 IHC 适当性更好(82.41% 对 66.67%,P< 0.001),诊断准确性更高(74.37% 对 55.42%,P< 0.001)。在控制了包括针头大小、病变部位、病变大小和内镜医师在内的混杂因素后,FNB 在 IHC 适当性(几率比 2.786 [1.515-5.291])和诊断准确性(几率比 2.793 [1.645-4.808])方面仍显著优于 FNA。在亚组分析中,FNB 对 AIP 和间质瘤的诊断准确率更高,而对 NET 和淋巴瘤的诊断准确率则无统计学差异。这些结果表明,FNB 应被视为诊断 IHC 要求病变(尤其是 AIP 和间质瘤)的一线方法。不过,还需要样本量更大的随机对照试验来进一步证实我们的研究结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fine needle biopsy versus fine needle aspiration in the diagnosis of immunohistochemistry-required lesions: A multicenter study with prospective evaluation

Objectives 

The superiority of EUS–guided fine-needle biopsy (EUS-FNB) over fine-needle aspiration (FNA) remains controversial. This study aimed to compare the efficacy of FNB and FNA in immunohistochemistry (IHC)-required lesions, including, type 1 autoimmune pancreatitis (AIP), neuroendocrine tumor (NET), mesenchymal tumor, and lymphoma.

Methods 

In this multicenter study, specimens from all eligible patients who underwent EUS-FNB/FNA with these specific lesions were prospectively evaluated. Demographics, adequacy of specimens for IHC, diagnostic accuracy, and integrity of tissue were analyzed. Subgroup analysis and multivariate logistic regression were also performed to control confounders.

Results 

A total of 439 patients were included for analysis. Most lesion types were type 1 AIP (41.69%), followed by NET, mesenchymal tumor, and lymphoma. FNB yielded specimens with better adequacy for IHC (82.41% vs. 66.67%, P < 0.001) and higher diagnostic accuracy (74.37% vs. 55.42%, P < 0.001). The superiority of FNB over FNA in adequacy for IHC (odds ratio, 2.786 [1.515–5.291]) and diagnostic accuracy (odds ratio, 2.793 [1.645–4.808]) remained significant after control of confounders including needle size, lesion site, lesion size, and endoscopists. In subgroup analysis, FNB showed higher diagnostic accuracy in AIP and mesenchymal tumor, whereas no statistically significant difference was observed in NET and lymphoma.

Conclusions 

FNB was superior to FNA needles in obtaining tissues with better adequacy and integrity. These results suggest that FNB should be considered a first-line modality in the diagnosis of IHC-required lesions, especially AIP and mesenchymal tumor. However, a randomized controlled trial with larger sample size is needed to further confirm our findings.

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来源期刊
Endoscopic Ultrasound
Endoscopic Ultrasound GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
6.20
自引率
11.10%
发文量
144
期刊介绍: Endoscopic Ultrasound, a publication of Euro-EUS Scientific Committee, Asia-Pacific EUS Task Force and Latin American Chapter of EUS, is a peer-reviewed online journal with Quarterly print on demand compilation of issues published. The journal’s full text is available online at http://www.eusjournal.com. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs.
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