The Diagnostic Yield of Fine Needle Aspiration and Biopsy Needles According to Needle Passes Number in Diagnosing Pancreatic Adenocarcinoma

Aims Endoscopic ultrasound guided fine needle aspiration/biopsy (EUS-FNA/FNB) is the main diagnostic tool for solid pancreatic lesions. However, it is associated with limited diagnostic yield.

Aim: we aimed to assess the optimal needle passes number of FNA\FNB needles to achieve maximum diagnostic yield

Methods We performed a retrospective study including all patients who were diagnosed with pancreatic adenocarcinoma by EUS-FNA\FNB. The diagnostic yield was reported for all needles according to needle passes number [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16].

Results Overall, 227 patients underwent EUS-FNA/FNB. FNBs in 85 patients (37.4%), and FNA in 142 patients (62.5%). The needle number passes in the FNB was 1.46±0.70 vs. 2.11±1.12 in the FNA group (P<0.0001). One, two and three needle passes yielded a diagnosis rate of malignancy in 76.8%, 68.4% and 70% of cases respectively for histology, while for cytology, the yield was 78.6%, 89.4% and 100%, respectively. For FNB needle types, the acquire needle outperformed the other needle, as the histological yield for one pass was 78.6%, 80% for two passes and 57.1% for three passes, while for cytology, the yield was 79.3%, 90% and 100% for one, two and three passes, respectively. For the FNA needle, the cytological yield was 88.7% for one pass, and higher for two and three passes

Conclusions our study demonstrated the diagnostic yield of needle passes number of both FNA and FNB needles. Overall, the optimal needle passes in FNB and FNA were 2, and 3-4 passes, respectively. Further large multicenter prospective studies are needed to better identify the optimal needle passes number in each FNA, and FNB needle types.

Publication History

Article published online:
27 March 2025

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