TY - JOUR
T1 - Comparison of Endoscopic Ultrasound–Fine-Needle Aspiration and Endoscopic Ultrasound–Fine-Needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial
AU - The New York Endoscopic Research Outcomes Group (NYERO)
AU - Nagula, Satish
AU - Pourmand, Kamron
AU - Aslanian, Harry
AU - Bucobo, Juan Carlos
AU - Gonda, Tamas A.
AU - Gonzalez, Susana
AU - Goodman, Adam
AU - Gross, Seth A.
AU - Ho, Sammy
AU - DiMaio, Christopher J.
AU - Kim, Michelle K.
AU - Pais, Shireen
AU - Poneros, John M.
AU - Robbins, David H.
AU - Schnoll-Sussman, Felice
AU - Sethi, Amrita
AU - Buscaglia, Jonathan M.
N1 - Publisher Copyright:
© 2018 AGA Institute
PY - 2018/8
Y1 - 2018/8
N2 - Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3%), and 139 patients were randomized to FNB (50.7%).The following lesions were sampled: mass (n = 210, 76.6%), lymph nodes (n = 46, 16.8%), and submucosal tumors (n = 18, 6.6%). Final diagnosis was malignancy (n = 192, 70.1%), reactive lymphadenopathy (n = 30, 11.0%), and spindle cell tumors (n = 24, 8.8%). FNA had a diagnostic yield of 91.1% compared with 88.5% for FNB (P =.48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.
AB - Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3%), and 139 patients were randomized to FNB (50.7%).The following lesions were sampled: mass (n = 210, 76.6%), lymph nodes (n = 46, 16.8%), and submucosal tumors (n = 18, 6.6%). Final diagnosis was malignancy (n = 192, 70.1%), reactive lymphadenopathy (n = 30, 11.0%), and spindle cell tumors (n = 24, 8.8%). FNA had a diagnostic yield of 91.1% compared with 88.5% for FNB (P =.48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.
KW - Endoscopic Ultrasound
KW - Fine Needle Aspiration
KW - Fine Needle Biopsy
KW - NYERO
KW - New York Endoscopic Research Outcomes Group
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U2 - 10.1016/j.cgh.2017.06.013
DO - 10.1016/j.cgh.2017.06.013
M3 - Article
C2 - 28624647
AN - SCOPUS:85030645296
SN - 1542-3565
VL - 16
SP - 1307-1313.e1
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 8
ER -