Comparison of Ultrasound‐Guided Core Needle Biopsy and Endoscopic Ultrasound‐Guided Fine‐Needle Aspiration for Solid Pancreatic Lesions

摘要

Objectives The objective of our study was to compare the diagnostic yield of endoscopic ultrasound (EUS)‐guided fine‐needle aspiration (FNA) using a 25‐gauge needle and ultrasound (US)‐guided core needle biopsy (CNB) using an 18‐gauge core needle for diagnosis of solid pancreatic lesions. Methods This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Patients who underwent either EUS‐guided FNA or US‐guided CNB for a solid pancreatic lesion from January 2008 to December 2012 were included and reviewed. Fine‐needle aspirations and CNBs were performed by experienced endoscopists and radiologists. The diagnostic yield, accuracy, technical failure rate, sensitivity, and specificity for malignancy were calculated and compared. Results A total of 106 biopsy attempts were undertaken in 89 patients (EUS‐guided FNA, n = 70; US‐guided CNB, n = 36). Biopsy specimens were successfully obtained in 98 biopsy attempts (EUS‐guided FNA, n = 63; US‐guided CNB, n = 35). The accuracy, technical failure rate, sensitivity, and specificity of EUS‐guided FNA for malignancy (73.02%, 10.00%, 77.78%, and 44.44%, respectively) was not significantly different from those of US‐guided CNB (88.57%, 2.78%, 87.10%, and 100%, respectively; P ≥ .089). Diagnostic performance did not differ between the modalities according to the size and the location of the lesion in the pancreas. However, the diagnostic yield of US‐guided CNB (86.11%) was higher than that of EUS‐guided FNA (65.71%, P = .035). Conclusions The diagnostic yield of US‐guided CNB for solid pancreatic lesions is superior to that of EUS‐guided FNA.