Endoscopic Ultrasound Fine-Needle Biopsy versus Fine-Needle Aspiration for Tissue Sampling of Abdominal Lymph Nodes: A Propensity Score Matched Multicenter Comparative Study

Abstract

There is a paucity of evidence on the comparison between endoscopic ultrasound (EUS) fine-needle biopsy (FNB) and fine-needle aspiration (FNA) for lymph node (LNs) sampling. The aim of this study was to compare these two approaches in a multicenter series of patients with abdominal tumors. Out of 502 patients undergoing EUS sampling, two groups following propensity score matching were compared: 105 undergoing EUS-FNB and 105 undergoing EUS-FNA. The primary outcome was diagnostic accuracy. Secondary outcomes were diagnostic sensitivity, specificity, sample adequacy, optimal histological core procurement, number of passes, and adverse events. Median age was 64.6 years, and most patients were male in both groups. Final diagnosis was LN metastasis (mainly from colorectal cancer) in 70.4% of patients in the EUS-FNB group and 66.6% in the EUS-FNA group (p = 0.22). Diagnostic accuracy was significantly higher in the EUS-FNB group as compared to the EUS-FNA group (87.62% versus 75.24%, p = 0.02). EUS-FNB outperformed EUS-FNA also in terms of diagnostic sensitivity (84.71% vs. 70.11%; p = 0.01), whereas specificity was 100% in both groups (p = 0.6). Sample adequacy analysis showed a non-significant trend in favor of EUS-FNB (96.1% versus 89.5%, p = 0.06) whereas the histological core procurement rate was significantly higher with EUS-FNB (94.2% versus 51.4%; p < 0.001). No procedure-related adverse events were observed. These findings show that EUS-FNB is superior to EUS-FNA in tissue sampling of abdominal LNs.

Needle Tract Seeding after Endoscopic Ultrasound Tissue Acquisition of Pancreatic Lesions: A Systematic Review and Meta-Analysis

“…While EUS-FNA may still play a competitive role as compared to EUS-FNB when rapid-on-site cytological evaluation (ROSE) is available, EUS-FNB was found to overperform standard FNA for tissue sampling of several solid lesions in the absence of a pathologist in the endoscopic room [ 3 , 4 , 5 , 6 ]. Moreover, in spite of the favorable diagnostic outcomes of EUS through-the-needle biopsy (TTNB) and confocal laser endomicroscopy (CLE), EUS-FNA is still frequently used in the diagnostic algorithm of cystic pancreatic lesions (PCLs) [ 7 , 8 , 9 ].…”

Outcome of Endoscopic Ultrasound-Guided Sampling of Mediastinal Lymphadenopathy

“…In a most recent study comparing the EUS-guided fine needle biopsy (FNB) vs. EUS-guided FNA in abdominal LN lesions, diagnostic accuracy was significantly higher in the EUS-FNB group as compared to the EUS-FNA group (87.62% versus 75.24%, P = 0:02). These findings suggested that EUS-FNB can be preferred to EUS-FNA for sampling intra-abdominal LNs in patients with suspected malignancy [23].…”

Transesophageal endoscopic ultrasound in the diagnosis of the lung masses: a multicenter experience with fine-needle aspiration and fine-needle biopsy needles

“…The use of EUS-FNB needles has generated a great deal of interest in the field of EUS-TA for several abdominal and submucosal lesions [19,20,21] primarily based on proposed advantages over EUS-FNA needles, namely improving diagnostic accuracy, improving procurement of samples with preserved tissue architecture, and allowing for immunohistochemistry or special stains required for certain diagnoses.…”

“…Attention should be paid to pneumothorax, but when a pulmonary mass is so close to the esophagus to be seen with ultrasound, no air is in between the two structures and the risk of pneumothorax is very low when the needle moves inside the solid mass. The use of EUS-FNB needles has generated a great deal of interest in the field of EUS-TA for several abdominal and submucosal lesions [19,20,21] primarily based on proposed advantages over EUS-FNA needles, namely improving diagnostic accuracy, improving procurement of samples with preserved tissue architecture, and allowing for immunohistochemistry or special stains required for certain diagnoses.…”