Clin Endosc.  2019 Nov;52(6):541-548. 10.5946/ce.2019.127.

Present and Future of Endoscopic Ultrasound-Guided Tissue Acquisition in Solid Pancreatic Tumors

• Park JK
• Lee KH

• KMID: 2465796
• DOI: http://doi.org/10.5946/ce.2019.127

Abstract

Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is a well-established method for pathological diagnosis of solid pancreatic neoplasm. It can be performed either as EUS-guided fine-needle aspiration (EUS-FNA) or EUS-guided fine-needle biopsy (EUS-FNB). The incidence of adverse events related to EUS-TA is less than 1%. The factors that affect the diagnostic accuracy and specimen adequacy include the techniques used, type and size of the needle, competency of endosonographers, presence of cytopathologists/cytotechnologists, and rapid on-site examination. EUS-TA may contribute to precision medicine through obtaining tissue samples for next-generation sequencing. The current status, several clinical issues for diagnostic yield and adverse events, and future perspectives of EUS-FNA/FNB for diagnosing pancreatic neoplasm have been discussed in this review article.

Keyword

Endoscopic ultrasound; Endoscopic ultrasound-guided fine-needle aspiration; Fine-needle biopsy; Pancreatic neoplasm

MeSH Terms

Biopsy, Fine-Needle
Diagnosis
Incidence
Methods
Needles
Pancreatic Neoplasms
Precision Medicine

Figure

• 

  Fig. 1. Tip of a trucut fine-needle biopsy needle (QuickCore® needle; Cook Medical, Inc., Winston-Salem, NC, USA).

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  Fig. 2. Tips of three different endoscopic ultrasound-guided fine-needle biopsy needles: (A) Procore® needles; Cook Medical, Inc., Winston-Salem, NC, USA). (B) Acquire™ end-cutting needle (Boston Scientific Co., Marlborough, MA, USA). (C) SharkCore™ needle (Medtronic, Minneapolis, MN, USA).

• 

  Fig. 3. Next-generation sequencing with key mutation gene: (A) Gene list of the panel. (B) Gene mutation frequencies. (C) Frequency of major genes in pancreatic cancer. (D) Genetic alterations associated with survivial after univariate analysis.

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