Agreement on endoscopic ultrasonography-guided tissue specimens: Comparing a 20-G fine-needle biopsy to a 25-G fine-needle aspiration needle among academic and non-academic pathologists
van Riet, P. A.; Cahen, D. L.; Biermann, K.; Hansen, B.; Larghi, A.; Rindi, G.; Fellegara, G.; Arcidiacono, P.; Doglioni, C.; Liberta Decarli, N.; IGLESIAS GARCIA, JULIO; ABDULKADER NALLIB, IHAB; LAZARE IGLESIAS, HECTOR; Kitano, M.; Chikugo, T.; Yasukawa, S.; van der Valk, H.; Nguyen, N. Q.; Ruszkiewicz, A.; Giovannini, M.; Poizat, F.; van der Merwe, S.; Roskams, T.; Santo, E.; Marmor, S.; Chang, K.; Lin, F.; Farrell, J.; Robert, M.; Bucobo, J. C.; Heimann, A.; Baldaque-Silva, F.; Fernández Moro, C.; Bruno, M. J.
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Fecha de publicación
2019Título de revista
Digestive Endoscopy
Tipo de contenido
Artigo
Resumen
BACKGROUND AND AIM: A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists. METHODS: This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re-reviewed by five expert academic and five non-academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non-academic pathologists, target lesions, and cytology versus histological specimens. RESULTS: Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (k = 0.59 vs k = 0.76, P < 0.001) and classification according to Bethesda (k = 0.45 vs k = 0.61, P < 0.001). This equally applied for expert academic and non-academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB, but agreement ranged from poor (k = 0.04) to fair (k = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB (P = 0.004 vs P = 0.432). CONCLUSION: This study shows that the 20-G FNB outperforms the 25-G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20-G FNB needle in both expert and lower volume EUS centers.
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