Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Biopsy Device for Lymphadenopathy.

Yuki Tanisaka,Tomoaki Tashima,Masahiro Suzuki,Masami Yasuda,Akashi Fujita,Kazuya Miyaguchi,Hiromune Katsuda,Masafumi Mizuide,Tomoya Ogawa,Yumi Mashimo,Ryuichiro Araki,Youichi Saito,Shomei Ryozawa,Konstantinos Triantafyllou

doi:10.1155/2021/6640862

Yuki Tanisaka, Tomoaki Tashima + Show 12 more

Open Access

https://doi.org/10.1155/2021/6640862

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Abstract

Background Accurate diagnosis of benign and malignant lymphadenopathy is important for determining the appropriate treatment and prognosis. This study evaluated the diagnostic accuracy and usefulness of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a conventional needle compared to endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) with a Franseen needle for diagnosing lymphadenopathy. Methods Patients who underwent EUS-FNA or EUS-FNB for mediastinal or abdominal lymphadenopathy between July 2013 and August 2020 were enrolled in the study. The outcomes between EUS-FNA patients (July 2013 to January 2017; 22-gauge conventional needle; Group A) and EUS-FNB patients (February 2017 to August 2020; 22-gauge Franseen needle; Group B) were compared. Results A total of 154 patients (Group A: 83; Group B: 71) were analyzed. The diagnostic accuracy (differentiating between malignant and benign lesions) was 88.0% (95% confidence interval [CI], 79.2–93.3%) in Group A and 95.8% (95% CI, 88.3–98.8%) in Group B. Group B had high diagnostic accuracy, but there was no difference between the groups (p = 0.14). Group B had significantly fewer passes (median 2, interquartile range (IQR): 2-4) than Group A (median 3, IQR: 3-4) (p < 0.001). No procedural adverse events occurred in either group. Conclusions Although the diagnostic accuracy between the groups was not statistically significant, EUS-FNB with a Franseen needle provided high diagnostic accuracy and required fewer passes to establish a diagnosis. Thus, EUS-FNB is useful for diagnosing lymphadenopathy.

Highlights

Mediastinal and abdominal lymphadenopathy present with numerous symptoms, and accurate diagnosis is important to determine the appropriate treatment and prognosis [1]
83 patients were included in the endoscopic ultrasound-guided fineneedle aspiration (EUS-fine-needle aspiration (FNA)) group (Group A)
Previous reports stated that the lymphadenopathy diagnostic accuracy using a conventional needle was over 85% [9,10,11,12,13,14,15,16], making it difficult to show significant differences compared to that obtained using a Franseen needle

Summary

Introduction

Mediastinal and abdominal lymphadenopathy present with numerous symptoms, and accurate diagnosis is important to determine the appropriate treatment and prognosis [1]. Cross-sectional imaging, such as computed tomography, magnetic resonance imaging, and positron emission tomography, is useful for detecting lymphadenopathy, it is difficult to distinguish between benign and malignant lesions using only imaging modalities [2,3,4]. Invasive procedures, such as open thoracic surgery, thoracoscopy, and laparoscopy, were previously required for histological diagnosis. The diagnostic accuracy between the groups was not statistically significant, EUS-FNB with a Franseen needle provided high diagnostic accuracy and required fewer passes to establish a diagnosis.

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