Clinical Endoscopy (Jan 2023)

A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer

  • Tadayuki Takagi,
  • Mitsuru Sugimoto,
  • Hidemichi Imamura,
  • Yosuke Takahata,
  • Yuki Nakajima,
  • Rei Suzuki,
  • Naoki Konno,
  • Hiroyuki Asama,
  • Yuki Sato,
  • Hiroki Irie,
  • Jun Nakamura,
  • Mika Takasumi,
  • Minami Hashimoto,
  • Tsunetaka Kato,
  • Ryoichiro Kobashi,
  • Yuko Hashimoto,
  • Goro Shibukawa,
  • Shigeru Marubashi,
  • Takuto Hikichi,
  • Hiromasa Ohira

DOI
https://doi.org/10.5946/ce.2022.019
Journal volume & issue
Vol. 56, no. 1
pp. 107 – 113

Abstract

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Background/Aims Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC. Methods A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA. Results No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation. Conclusions EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

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