Diagnostic ability of EUS-FNA for pancreatic solid lesions with conventional 22-gauge needle using the slow pull technique: a prospective study.
OBJECTIVE
Endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) using the slow pull technique (SP-FNA) has recently attracted attention as an effective tissue acquisition technique. However, efficacy of SP-FNA with a 22-gauge conventional needle remains unclear. The aim of this study is to evaluate the diagnostic ability of SP-FNA with a 22-gauge needle.


METHODS
Patients with a pancreatic solid lesion were prospectively enrolled in this study. SP-FNA was performed at two needle passes with a 22-gauge needle. One dedicated pathologist evaluated the obtained samples in terms of quantity (Grade 0: scant; Grade 1: inadequate; Grade 2: adequate), quality (Grade 0: poor; Grade 1: moderate; Grade 2: good), and blood contamination (Grade 0: significant; Grade 1: moderate; Grade 2: low), and provided a pathological diagnosis. Additional EUS-FNA was performed by applying suction (SA-FNA). The evaluation points were as follows: diagnostic accuracy of SP-FNA compared with that of SA-FNA, and the quantity, quality, and blood contamination level of SP-FNA-obtained samples.


RESULTS
We enrolled 40 cases. The diagnostic accuracy of SP-FNA was 90% (36/40). There was no significant difference in the accuracy between SP-FNA and SA-FNA (90% vs. 90%, p = 1.000). The samples obtained using SP-FNA were assessed as Grade 2 for quantity in 29 cases (73%), quality in 31 (78%), and blood contamination in 25 (63%).


CONCLUSIONS
Adequate, high-quality, and unsubstantially blood-contaminated samples could be obtained using SP-FNA. The diagnostic ability of SP-FNA was 90%, which appeared to be similar to that of SA-FNA.
Center for Gastroenterology, Teine-Keijinkai Hospital , 1-40/1-12 Maeda, Teine-ku, Sapporo, Hokkaido, 006-8555 , Japan.
Toshifumi
T
Kin
Akio
A
Katanuma
Kei
K
Yane
Kuniyuki
K
Takahashi
Manabu
M
Osanai
Ryo
R
Takaki
Kazuyuki
K
Matsumoto
Katsushige
K
Gon
Tomoaki
T
Matsumori
Akiko
A
Tomonari
Hiroyuki
H
Maguchi
Toshiya
T
Shinohara
Masanori
M
Nojima
D000368:Aged; D000369:Aged, 80 and over; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000009:adverse effects / Q000295:instrumentation* / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009339:Needles; D018358:Neuroendocrine Tumors / Q000175:diagnosis* / Q000473:pathology; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies
EUS-FNA; pancreatic solid lesion; slow pull technique; suction