title: 25-gauge histology needle versus 22-gauge cytology needle in endoscopic ultrasonography-guided sampling of pancreatic lesions and lymphadenopathy.
abstract: OBJECTIVE
  A new 25-gauge (G) endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) device (EchoTip ProCore; Cook Medical, Bloomington, Indiana, USA) has been developed, which features a hollowed-out reverse bevel to trap core samples. However, data on the differences between the diagnostic yield of the 25G EchoTip ProCore and that of a 22G standard needle are limited.
  
  
  METHODS
  This pilot study included 27 patients referred during an 11-month period for EUS-FNA of pancreatic masses and enlarged lymph nodes adjacent to the upper gastrointestinal tract. Each lesion was punctured once by both a 25G EchoTip ProCore needle and a 22G standard needle (EchoTip; Cook Medical) with capillary sampling. Blinded histocytologic analyses were conducted. The final diagnosis was based on FNA findings of malignant cells, pathologic analysis of the surgical specimen, and/or radiologic and clinical follow-up of at least 7 months.
  
  
  RESULTS
  A total of 28 EUS-FNA procedures targeting masses of the pancreas (n = 19) and lymph nodes (n = 9) were performed. No complications were encountered. Single-pass sensitivity rates for pancreatic and lymph node malignancy were equal for the needle types: 89.5 % (95 %CI 66.82 - 98.39) and 66 % (95 %CI 24.1 - 94), respectively. There were no significant differences between the needles in terms of EUS visualization (P = 0.125), amount of blood contamination (P = 0.705), macroscopic quantity of the material (P = 0.858), quality of the cytology (P = 0.438), and adequacy and accuracy of the cell block material (P = 0.220).
  
  
  CONCLUSIONS
  Both needles were safe and successful in terms of a high diagnostic yield, with similar histocytologic results. The results of this study were presented at Digestive Disease Week (DDW) 2014, Chicago, Illinois. This trial was registered at ClinicalTrials.gov (B027201316271).
authors.affiliation: Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium ; Department of Hepato-gastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Georgios
authors.initials: G
authors.lastname: Mavrogenis
authors.affiliation: Department of Pathology, Centre Hospitalier Universitaire Dinant Godinne, Université Catholique de Louvain, Yvoir, Belgium.
authors.forename: Birgit
authors.initials: B
authors.lastname: Weynand
authors.affiliation: Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors.forename: Alain
authors.initials: A
authors.lastname: Sibille
authors.affiliation: Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors.forename: Hocine
authors.initials: H
authors.lastname: Hassaini
authors.affiliation: Department of Hepato-gastroenterology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Deprez
authors.affiliation: Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors.forename: Cédric
authors.initials: C
authors.lastname: Gillain
authors.affiliation: Department of Gastroenterology, Grand Hôpital de Charleroi, Charleroi, Belgium.
authors.forename: Philippe
authors.initials: P
authors.lastname: Warzée