Emrah ALPER, ALTAY KANDEMİR, Mahmut ARABUL, MUSTAFA ÇELİK, FATİH ASLAN, Işık ALPER, Belkıs ÜNSAL

Pankreas kitlelerinin endosonografi ile örneklemesinde 19 gauge iğne aspirasyon ve 19 gauge tru-cut biyopsi benzer etkinlik ve güvenilirliktedir

Bu çalışmada yerinde sitopatolojik inceleme yapılamayan ortamda pankreas gövde kesimde yerleşik fokal pankreatik kitlelerden örnek alınmasında 19-gauge endoskopik ultrason - ince iğne aspirasyon biyopsisi ile 19 gauge endoskopik ultrason tru-cut biyopsinin örneklemedeki hücresel yeterliliğini ve güvenilirliğini karşılaştırmayı amaçladık. Gereç ve Yöntem: İzmir Atatürk Eğitim ve Araştırma Hastanesi Gastroenteroloji kliniğinde endosonografi kullanılarak doku örneklemesi yapılan 48 hasta çalışmaya dahil edildi. Bir gruba (n=26) 19 gauge endoskopik ultrason ince iğne aspirasyon ile, diğer gruba (n=22) 19 gauge tru-cut biopsi ile pankreas kitle örneklemesi yapıldı. Bulgular: İşlem tekrar sayısına bakılmaksızın, yeterli örnekleme yapılma oranı 19- gauge ince iğne aspirasyon biyopside %92.3 ve 19 gau- ge tru-cut biyopside %90.9, ince iğne aspirasyon biyopsisi grubunda 1. seansta hücresel yeterlilik oranı %69.2 % , tru-cut biyopsi grubunda 1. seansta hücresel yeterlilik oranı %72.7 idi (p>0 ,05). İnce iğne aspirasyon biyopsiside hücre bloğu elde edilme oranı %23 iken, tru-cut biyopsi'de %45 idi (P

Anahtar Kelimeler:

Tru-cut biopsi, İnce iğne aspirasyon biopsisi, pankreatik kitle

19 G needle aspiration and 19 g tru-cut biopsy are similar reliable and efficient in sampling of pancreatic mass with endosonography

In this study, we aimed to compare the reliability and efficiency of 19 gauge fine needle aspiration and 19 gauge TruCut needle biopsy in the sampling of pancreatic body mass with endosonography, in those conditions when diagnosis cannot be made by on-site pathological evaluation. Materials and Methods: Forty-eight patients seen at Izmir Ataturk Training and Research Hospital, Department of Gastroenterology, in whom pancreatic body mass sampling was performed with endosonography were enrolled in this study. 19 gauge endosonography with fine needle aspiration was performed in one group (n=26) and 19 gauge Tru-Cut needle biopsy sampling in the other (n=22). Results: An adequate sampling rate was achieved regardless of the number of sessions, with 92.3% with 19 gauge fine needle aspiration and 90.9% with 19 gauge Tru-Cut needle biopsy. Adequacy of cellularity ratio in the first session was 69.2% with fine needle aspiration and 72.7% with Tru-Cut needle biopsy (p>0.05). While the ratio of obtaining cell block from fine needle aspiration was 23%, this ratio was 45% with Tru-Cut needle biopsy (p

Keywords:

Tru-Cut needle biopsy fine needle aspiration, endosonography, pancreas,

PDF

___

Fritscher-Ravens A, Izbicki JR, Sriram PV, et al. Endosonography- guided, fine-needle aspiration cytology extending the indication for organ-preserving pancreatic surgery. Am J Gastroenterol 2000; 95: 2255-60.
Jenssen C, Dietrich CF. Endoscopic ultrasound-guided fine-needle aspiration biopsy and trucut biopsy in gastroenterology – An over- view. Best Pract Res Clin Gastroenterol 2009; 23: 743-59.
Jenssen C, Moller K, Wagner S, Sarbia M. Endoscopic ultrasound- guided biopsy: diagnostic yield, pitfalls, quality management. Part 1: optimizing specimen collection and diagnostic efficiency. Z Gas- troenterol 2008; 46: 590-600.
Itoi T, Itokawa F, Sofuni A, et al. Puncture of solid pancreatic tu- mors guided by endoscopic ultrasonography: a pilot study series comparing trucut and 19-gauge and 22-gauge aspiration needles. Endoscopy 2005; 37: 362-6.
Wittmann J, Kocjan G, Sgouros SN, et al. Endoscopic ultrasound- guided tissue sampling by combined fine needle aspiration and tru- cut needle biopsy: A prospective study. Cytopathology 2006; 17: 27-33.
Sakamoto H, Kitano M, Komaki T, et al. Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pan- creatic masses. J Gastroenterol Hepatol 2009; 24: 384-90.
Yun SS, Remotti H, Vazquez MF, et al. Endoscopic ultrasound-gui- ded biopsies of pancreatic masses: comparison between fine need- le aspirations and needle core biopsies. Diagn Cytopathol 2007; 35: 276-82.
Gines A, Wiersema MJ, Clain JE, et al. Prospective study of a tru- cut needle for performing EUS-guided biopsy with EUS-guided FNA rescue. Gastrointest Endosc 2005; 62: 597-601.
Affi A, Vazquez-Sequeiros E, Norton ID, et al. Acute extraluminal hemorrhage associated with EUS-guided fine needle aspiration: frequency and clinical significance. Gastrointest Endosc 2001; 53: 221-5.
Voss M, Hammel P, Molas G, et al. Value of endoscopic ultraso- und guided fine needle aspiration biopsy in the diagnosis of solid pancreatic masses. Gut 2000; 46: 244-9.
Jenssen C, Faiss S, Nurnberg D. Complications of endoscopic ultra- sound and endoscopic ultrasound-guided interventions - results of a survey among German centers. Z Gastroenterol 2008; 46: 1177- 84.