Background and Aims

Through-the-needle microforceps are a recent addition to the EUS armamentarium for evaluation of pancreatic cystic lesions (PCLs). The main aim of this study was to assess the technical feasibility, diagnostic yield, and safety of EUS-guided microforceps biopsy for PCLs.

Methods

Our electronic endoscopy database was queried to identify patients who underwent EUS-guided FNA (EUS-FNA) of PCLs and microforceps biopsies during the same procedure. A biopsy was done on the wall of the cyst with the microforceps through the 19-gauge needle, and cyst fluid was collected for cytology and carcinoembryonic antigen (CEA) levels. Adverse events were recorded per published American Society for Gastrointestinal Endoscopy criteria.

Results

Twenty-seven patients underwent EUS-FNA and microforceps biopsy of PCLs from February 2016 to July 2017. Fourteen cysts were located in the pancreatic head and/or uncinate, and 13 were located in the body and/or tail region. Microforceps biopsies were technically successful in all cases and provided a pathology diagnosis in 24 of 27 cases (yield 88.9%). Microforceps biopsies diagnosed mucinous cyst in 9 patients (33.3%), serous cystadenoma in 4 (14.8%), neuroendocrine tumor in 1 (3.7%), and benign and/or inflammatory cyst in 10 (37.1%). In 7 patients (26%), microforceps biopsy results drastically changed the diagnosis, providing diagnoses otherwise not suggested by cytology or cyst fluid CEA levels. However, cytology provided a diagnosis of mucinous cyst in 4 cases (14.8%) not detected by microforceps biopsies. No adverse events were noted.

Conclusion

Microforceps biopsies were associated with high technical success, and an excellent safety profile and may be a useful adjunctive tool, complementing existing EUS-FNA sampling protocols for PCLs.

中文翻译：

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EUS评估胰腺囊性病变期间显微钳活检的技术可行性，诊断率和安全性（带视频）

背景和目标

穿刺式微型镊子是EUS武器库中最近用于评估胰腺囊性病变（PCL）的一种工具。这项研究的主要目的是评估EUS引导的PCLs显微钳活检的技术可行性，诊断率和安全性。

方法

查询我们的电子内窥镜数据库，以识别在同一过程中接受EUS指导的PCL和微钳活检的FNA（EUS-FNA）的患者。用微型镊子通过19号针头对囊壁进行活检，并收集囊液以进行细胞学检查和癌胚抗原（CEA）水平。根据美国胃肠道内窥镜检查学会标准记录不良事件。

结果

从2016年2月至2017年7月，对27例患者进行了EUS-FNA和微钳活检PCL。14个囊肿位于胰头和/或癌突，而13个位于身体和/或尾巴区域。在所有情况下，显微钳活检技术均成功，在27例病例中有24例提供了病理学诊断（产率88.9％）。显微钳活检诊断为粘液性囊肿9例（33.3％），浆液性囊腺瘤4例（14.8％），神经内分泌肿瘤1例（3.7％），良性和/或炎性囊肿10例（37.1％）。在7例患者（26％）中，微钳活检结果大大改变了诊断，提供了细胞学或囊肿性CEA水平未提示的诊断。然而，细胞学检查提供了4例（14.8％）粘液囊肿的诊断，而微钳活组织检查未检出。没有发现不良事件。

结论

显微钳活检具有很高的技术成功率和出色的安全性，并且可能是有用的辅助工具，是对PCL的现有EUS-FNA采样协议的补充。