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Short Communication
| Endoscopy 2005; 37: 362-366
DOI: 10.1055/s-2004-826156 |
© Georg Thieme Verlag KG Stuttgart · New York |
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Puncture of Solid Pancreatic Tumors Guided by Endoscopic Ultrasonography: A Pilot Study Series Comparing Trucut and 19-Gauge and 22-Gauge Aspiration Needles |
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| T. Itoi1, F. Itokawa1, A. Sofuni1, K. Nakamura1, A. Tsuchida2, K. Yamao3, T. Kawai4, F. Moriyasu1 |
1 Fourth Department of Internal Medicine, Tokyo Medical University, Tokyo, Japan
2 Third Department of Surgery, Tokyo Medical University, Tokyo, Japan
3 Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
4 Endoscopic Center, Tokyo Medical University, Tokyo, Japan |
Background and Study Aims: The aim of this prospective study was to compare endoscopic ultrasonography-guided Trucut needle biopsy (EUS-TNB) with EUS-guided fine-needle aspiration biopsy (EUS-FNAB) using 19- and 22-gauge needles for biopsy from different sites in patients with solid pancreatic cancers.
Patients and Methods: Sixteen consecutive patients with masses in the uncinate process (n = 3), the head (n = 5), or the body and tail (n = 8) of the pancreas underwent both EUS-TNB and EUS-FNAB. The specimens obtained were evaluated by histopathological analysis alone
Results: Tissue specimens were obtained by Trucut needle, and by 19-gauge and 22-gauge aspiration needles in 69 %, 69 %, and 100 % of patients respectively. Sensitivity for malignancy was 69 % for all needles. Tissue sampling by Trucut and by 19-gauge aspiration needle from masses in the uncinate process was impossible. The sensitivity of the Trucut and 19-gauge aspiration needles was 100 % in the 11 patients with successful procedures. If Trucut or19-gauge aspiration needles had been used for body and tail masses, and the 22-gauge aspiration needle for masses in the uncinate process and head, the sensitivity for malignancy would have been 81 %.
Conclusions: EUS-TNB allows reliable tissue sampling for the diagnosis of pancreatic masses, but its use is limited to lesions in the body and tail of the pancreas. EUS-FNAB using a 22-gauge needle may be useful for accurate diagnosis in some patients with masses in the uncinate process or the head of the pancreas.
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