Endoscopy 2014; 46(12): 1063-1070
DOI: 10.1055/s-0034-1377559
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Core needle versus standard needle for endoscopic ultrasound-guided biopsy of solid pancreatic masses: a randomized crossover study

Geoffroy Vanbiervliet
1  Université de Nice Sophia Antipolis, Faculté de Médecine and Centre Hospitalier Universitaire de l’Archet 2, Pôle digestif, Nice, France
,
Bertrand Napoléon
2  Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
,
Marie Christine Saint Paul
3  Centre Hospitalier Universitaire Pasteur, Anatomopathologie, Nice, France
,
Charlotte Sakarovitch
4  Centre Hospitalier Universitaire Cimiez, Département de la recherche clinique, Nice, France
,
Marc Wangermez
5  Centre Hospitalier Universitaire de Poitiers, Gastroentérologie, Poitiers, France
,
Philippe Bichard
6  Hôpitaux Universitaires de Genève, Gastroentérologie, Genève, Switzerland
,
Clément Subtil
7  Centre hospitalier Universitaire du Haut-Lévêque, Gastroentérologie, Pessac, France
,
Stéphane Koch
8  Centre hospitalier Universitaire de Besançon, Gastroentérologie, Besançon, France
,
Philippe Grandval
9  Assistance publique des hôpitaux de Marseille, Hôpital de la Timone, Gastroentérologie, Marseille, France
,
Rodica Gincul
10  Hospices civils de Lyon, Gastroentérologie, Lyon, France
,
David Karsenti
11  Clinique de Bercy, Pôle digestif, Charenton le Pont, France
,
Laurent Heyries
12  Assistance publique des hôpitaux de Marseille, Hôpital de la Conception, Gastroentérologie, Marseille, France
,
Jean-Christophe Duchmann
13  Centre Hospitalier Général de Compiègne, Gastroentérologie, Compiègne, France
,
Jean François Bourgaux
14  Centre Hospitalier Universitaire Carémeau, Gastroentérologie, Nîmes, France
,
Michaël Levy
15  Assistance Publique des hôpitaux de Paris, Hôpital Mondor, Gastroentérologie, Créteil, France
,
Gilles Calament
16  Centre Hospitalier Universitaire de la Cavale Blanche, Gastroentérologie, Brest, France
,
Fabien Fumex
2  Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
,
Bertrand Pujol
2  Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
,
Christine Lefort
2  Hôpital Privé Mermoz, Gastroentérologie, Lyon, France
,
Laurent Poincloux
17  Centre Hospitalier Universitaire Estaing, Gastroentérologie, Clermont Ferrand, France
,
Maël Pagenault
18  Centre Hospitalier Universitaire de Pontchaillou, Gastroentérologie, Rennes, France
,
Eduardo Aimé Bonin
19  Assistance publique des hôpitaux de Marseille, Hôpital Nord, Gastroentérologie, Marseille, France
,
Monique Fabre
20  Gustave Roussy, Pathologie Morphologique, Villejuif, France
,
Marc Barthet
19  Assistance publique des hôpitaux de Marseille, Hôpital Nord, Gastroentérologie, Marseille, France
› Author Affiliations
Further Information

Publication History

submitted: 15 September 2013

accepted after revision: 12 June 2014

Publication Date:
06 August 2014 (online)

Background and study aims: A new core biopsy needle for endoscopic ultrasound (EUS)-guided sampling has recently been developed. The aim of this prospective multicenter study was to compare this needle with a standard needle in patients with solid pancreatic masses.

Patients and methods: Consecutive patients with solid pancreatic masses referred to 17 centers for EUS-guided sampling were included. Each patient had two passes with a standard 22G needle and a single pass with a 22G core needle performed in a randomized order. Samples from both needles were separately processed for liquid-based cytology and cell-block preparation and were assessed independently by two blinded expert pathologists. The primary endpoint was the accuracy of the detection of malignancy. The reference standard was based on further cytohistological analysis obtained under ultrasound or computed tomography scanning, endoscopic or surgical guidance, and/or by clinical follow-up with repeated imaging examinations for at least 12 months. The secondary endpoints were the rate of technical failure and the quality of the cytohistological samples obtained.

Results: Of the 80 patients included (49 men; mean age 67.1 ± 11.1), 87.5 % had final malignant diagnoses (adenocarcinoma n = 62, 77.5 %). There was no difference between the needles in diagnostic accuracy (standard needle 92.5 % vs. core needle 90 %; P = 0.68) or technical failure. Both pathologists found the overall sample quality significantly better for the standard needle (expert 1, P = 0.009; expert 2, P = 0.002).

Conclusions: The diagnostic accuracy of EUS sampling for solid pancreatic masses using standard and core needles seems comparable but with a better overall histological sample quality for the former.

ClinicalTrial.gov identifier: NCT01479803.