Mo1323 IMPACT OF A 20G CORE TRAP WITH A FORWARD-CUTTING BEVEL NEEDLE FOR ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF PANCREATIC LESIONS: A PROSPECTIVE EVALUATION

Abstract

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has been established as a method to obtain tissues of various organs. To obtain sufficient tissue has clinical impact to facilitate the diagnosis by clinical pathologists, the assessment and subtyping of various neoplasms, and for further immunohistochemical investigations of tumor type. Recently, a novel 20G core trap with a forward-cutting beveled FNA needle (ProC-F) has become available. This novel FNA needle has a core trap with a forward-cutting bevel, also with coiling seethe. Therefore, maneuvering of the FNA needle may be easy. The aim of this prospective study was to evaluate the feasibility and diagnostic yield of EUS-FNA for pancreatic lesions using this needle. In this study, the first puncture was performed using the ProC-F. The second puncture was performed using a 22G standard FNA needle. This prospective study was primarily aimed at investigating histological diagnostic yield of ProC-F. In this analysis, only tissue obtained with the first puncture using the ProC-F was used. Fifty-three consecutive patients who underwent EUS-FNA for pancreatic lesions were prospectively enrolled. The technical success rate of EUS-FNA using the ProC-F was 98.1% (52/53). The median size of the pancreatic tumors was 22 mm (range 10-55 mm). The locations of the pancreatic tumors were head (n=26), body (n=15), and tail (n=11). The rate of adequate tissue obtained by ProC-F was 96.2% (50/52). On the other hand, the rate of adequate tissue obtained by the standard needle was 71.1% (32/45). The sensitivity, specificity, predictive value (NPV), positive predictive value (PPV), and accuracy of the ProC-F and the standard needle were 92.5%, 100%, 100%, 76.9%, and 94.0%, and 85.2%, 100%, 100%, 55.6%, and 87.5%, respectively. Adverse events were not seen in any patients. In conclusion, though only tissue obtained by the first puncture was evaluated, the rate of adequate tissue and the histologic diagnostic yield for pancreatic lesions were extremely high using the ProC-F.