Is the New Procore 20g Double Forward-Bevel Needle Capable to Obtain Better Histological Samples by Endoscopic Ultrasound for Diagnosing Solid Pancreatic Lesions?

Abstract

Background: It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined. Aim: To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy. Methods: This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist. Results: The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively. Conclusions: The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.

Cistoadenoma Seroso De Pâncreas. Por Que a Acurácia É Baixa Aos Exames De Imagem?

“…A punção com análise do líquido aspirado durante o exame de EE tem sido sugerida por alguns como importante arma para melhorar o diagnóstico em casos duvidosos de cistos de pâncreas 4,7,12 . A despeito disso, a maioria dos guidelines recomenda a EE apenas como exame adjuvante à tomografia computadorizada e, preferencialmente, à ressonância magnética 15,16 .…”

“…Puncture with analysis of the aspirated liquid during EUS has been suggested by some as an important tool to improve the diagnosis in doubtful cases of pancreas cysts 4 , 7 , 12 . Despite this, most guidelines only recommend EUS as an adjunct to computed tomography and, preferably, to MRI 15 , 16 .…”

A Meta-Analysis Comparing Endoscopic Ultrasound-guided Fine-needle Aspiration With Endoscopic Ultrasound-guided Fine-needle Biopsy

“…The included period ranged from 2012 to 2021. Eleven RCTs 13,[15][16][17][19][20][21]24,[26][27][28] were parallel trials and 7 14,18,22,23,25,29,30 were cross-over studies. Six RCTs were conducted in Asia 14,15,19,20,23,24 and all studies presented 2 well balanced arms regarding lesion features (location and size) and clinical demographical characteristics.…”

Proteínas Mir-203a-3p E MMP-2 São Altamente Expressas Em Células Tumorais Circulantes De Pacientes Com Carcinoma Pancreático

“…Existe uma tendência geral de maiores taxas de incidência nos países desenvolvidos 15 . Embora não esteja entre os 10 principais cânceres no Brasil, é a oitava principal causa de morte por câncer, devido ao diagnóstico em estágio localmente avançado ou metastático da doença 4,20 . O subtipo histológico mais comum e também mais agressivo de pâncreas câncer é o adenocarcinoma ductal pancreático (ADP), que representa 85-90% de todas as neoplasias pancreáticas 3 .…”

“…There is a general trend of higher incidence rates in developed countries 15 . Although not among the top 10 cancers in Brazil, it is the eighth leading cause of death from cancer, due to diagnosis in locally advanced or metastatic stage of the disease 4 , 20 . The most common and also most aggressive histological subtype of pancreatic cancer is the pancreatic ductal adenocarcinoma (PDAC), which represents 85-90% of all pancreatic neoplasms 3 .…”