BACKGROUND AND AIMS Data on comparative efficacy of various available endoscopic ultrasound-guided liver biopsy (EUS-LB) needles are limited. We sought to compare the performance of a novel Franseen-tip 22G fine-needle biopsy (FNB) device to that of 19G needle platforms for liver parenchyma. METHODS Consecutive patients referred for EUS and suspected to have hepatic parenchymal disease underwent EUS-LB using different EUS needles and were included in this retrospective study. Two blinded expert liver pathologists independently reviewed and reported on: total number of tissue fragments, length of longest fragment, number of complete and incomplete portal tracts (CPT and IPT), and specimen adequacy. RESULTS A 22G Franseen-tip needle (A) was used in 30 patients; 19G Tru-Cut needle (B) in 50 patients; 19G reverse beveled non-Tru-Cut needle (C) in 27 patients; and a 19G flexible non-Tru-Cut needle (D) in 28 patients. In the order of needles, A, B, C and D,  > 10 tissue fragments were obtained in 100%, 6%, 82%, and 96% samples, the mean number of CPTs was 6.9; 3.0; 7.3; and 16.9, length of longest fragment was 3.8, 4. 7, 3.9, and 8.4 mm, and specimen adequacy was 66.7%, 46%, 82.1%, and 81.5%, respectively. A positive correlation was obtained between number of CPTs and length of longest fragment in samples accrued by 19G needles. CONCLUSION EUS-LB specimens using 22G Franseen-tip needle appear highly fragmented, leading to inferior specimen adequacy compared to 19G non-Tru-Cut needles. We also report on using length of longest fragment as an additional criterion for specimen adequacy as it positively correlates with number of CPTs standard.

中文翻译：

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EUS指导的实质性肝病活检的22G和19G针的比较研究：较细的针更好吗？

背景和目的关于各种可用的内窥镜超声引导肝活检（EUS-LB）针的比较功效的数据有限。我们试图比较新型Franseen尖端的22G细针活检（FNB）装置与19G肝实质针平台的性能。方法接受EUS的连续患者和怀疑患有肝实质疾病的患者均使用不同的EUS针进行了EUS-LB，并纳入了这项回顾性研究。两名不知情的专家肝脏病理学家独立审查并报告了以下信息：组织碎片总数，最长碎片长度，完整和不完整的门静脉道（CPT和IPT）数目以及标本是否足够。结果30例患者使用22G的Franseen针头（A）。19G Tru-Cut针头（B）50例；27例患者使用19G倒角非Tru-Cut针（C）；并在28例患者中使用19G柔性非Tru-Cut针（D）。按针头顺序，分别在100％，6％，82％和96％的样本中获得了> 10个组织碎片，CPT的平均数量为6.9；3.0; 7.3; 最长片段的长度为3.8、4、7、3.9和8.4 mm，分别为16.9和66.7％，46％，82.1％和81.5％。CPT数量与19G针头样品中最长片段的长度之间呈正相关。结论与19G非Tru-Cut针相比，使用22G Franseen尖头针的EUS-LB标本显得高度碎片化，导致标本充分性较差。我们还报告了使用最长片段的长度作为样本充分性的附加标准，因为它与CPT标准数量成正相关。