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KMID : 1038120230560010107
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Clinical Endoscopy
2023 Volume.56 No. 1 p.107 ~ p.113
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A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer
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Takagi Tadayuki
Nakamura Jun
Hashimoto Minami
Kato Tsunetaka
Kobashi Ryoichiro
Shibukawa Goro
Hikichi Takuto
Sugimoto Mitsuru
Suzuk Rei
Konno Naoki
Sato Yuki
Irie Hiroki
Takasumi Mika
Ohira Hiromasa
Imamura Hidemichi
Takahata Yosuke
Nakajima Yuki
Hashimoto Yuko
Marubashi Shigeru
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Abstract
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Background/Aims : Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC.
Methods : A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018?2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA.
Results : No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation.
Conclusions : EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.
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KEYWORD
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Endoscopic ultrasound-guided fine-needle aspiration, Endoscopic ultrasound-guided fine-needle biopsy, Franseen needle, Microsatellite instability, Pancreatic neoplasms
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