Clin Endosc.
2023 Jan;56(1):107-113. 10.5946/ce.2022.019.
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
- Takagi T
1 - Sugimoto M1
- Imamura H2
- Takahata Y3
- Nakajima Y3
- Suzuki R1
- Konno N1
- Asama H1
- Sato Y1
- Irie H1
- Nakamura J4
- Takasumi M1
- Hashimoto M4
- Kato T4
- Kobashi R4
- Hashimoto Y5
- Shibukawa G3
- Marubashi S6
- Hikichi T4
- Ohira H1
- Affiliations
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- 1Department of Gastroenterology, School of Medicine, Fukushima Medical University, Fukushima, Japan
- 2Department of Gastroenterology, Ohtanishinouchi Hospital, Koriyama, Japan
- 3Department of Gastroenterology, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu, Japan
- 4Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan
- 5Department of Diagnostic Pathology, School of Medicine, Fukushima Medical University, Fukushima, Japan
- 6Department of Hepato-Biliary-Pancreatic and Transplant Surgery, School of Medicine, Fukushima Medical University, Fukushima, Japan
- KMID: 2538758
- DOI: http://doi.org/10.5946/ce.2022.019
Abstract
- 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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