Gastrointestinal endoscopy · 2025
Impact of EUS-guided fine-needle biopsy sampling on International Consensus Diagnostic Criteria for diagnosing autoimmune pancreatitis: a prospective multicenter study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Conti Bellocchi Maria Cristina, Crinò Stefano Francesco, Ikeura Tsukasa, Carrara Silvia, Oh Dongwook, Nakamaru Koh, Terrin Maria, Song Tae Jun, Caldart Federico, Sina Sokol, De Pretis Nicolò, Manfrin Erminia, Frulloni Luca
Аннотация
BACKGROUND AND AIMS: Histologic diagnosis of autoimmune pancreatitis (AIP) may be difficult to obtain preoperatively. Based on promising results using new-generation "end-cutting" needles, we aimed to assess the utility of EUS-guided fine-needle biopsy (EUS-FNB) sampling in enhancing diagnostic levels of International Consensus Diagnostic Criteria (ICDC) in patients with probable AIP and in defining the specific AIP subtype.
METHODS: Adult patients with suspected AIP were prospectively and competitively enrolled at 4 centers. Definitive AIP diagnosis, according to the ICDC, or patients recently treated with steroids were excluded. A 22-gauge end-cutting needle was used in all cases. The primary outcome was the rate of enhanced ICDC levels. Secondary outcomes were rates of levels 1 or 2, EUS-FNB diagnostic accuracy, rate of malignancy, and safety.
RESULTS: Fifty-two patients with focal (50) and diffuse (2) suspected AIP were enrolled (75% men; mean age, 57.9 ± 17.3 years). Final diagnoses were AIP, chronic pancreatitis, and malignancy in 39 (75%), 6 (11.5%), and 7 (13.5%) patients, respectively. EUS-FNB improved the diagnostic level of AIP in 92.3% (74.3% definitive and 17.9% probable). The rate of histology level 1 compatible with a diagnosis of type 1 and type 2 AIP was 73.1% and 50%, respectively. The rate of histology level 2 was 23.1% and 41.7% in type 1 and type 2, respectively. The overall diagnostic accuracy of EUS-FNB was 94.2% (95% CI, 84.1-98.8). Two mild cases of pancreatitis (3.8%) occurred after EUS-FNB.
CONCLUSIONS: EUS-FNB using end-cutting needles enhanced the ICDC in >90% of patients, ruling out malignancy in focal presentations and defining the specific subtype of AIP. (Clinical trial registration number: NCT04397731.).
METHODS: Adult patients with suspected AIP were prospectively and competitively enrolled at 4 centers. Definitive AIP diagnosis, according to the ICDC, or patients recently treated with steroids were excluded. A 22-gauge end-cutting needle was used in all cases. The primary outcome was the rate of enhanced ICDC levels. Secondary outcomes were rates of levels 1 or 2, EUS-FNB diagnostic accuracy, rate of malignancy, and safety.
RESULTS: Fifty-two patients with focal (50) and diffuse (2) suspected AIP were enrolled (75% men; mean age, 57.9 ± 17.3 years). Final diagnoses were AIP, chronic pancreatitis, and malignancy in 39 (75%), 6 (11.5%), and 7 (13.5%) patients, respectively. EUS-FNB improved the diagnostic level of AIP in 92.3% (74.3% definitive and 17.9% probable). The rate of histology level 1 compatible with a diagnosis of type 1 and type 2 AIP was 73.1% and 50%, respectively. The rate of histology level 2 was 23.1% and 41.7% in type 1 and type 2, respectively. The overall diagnostic accuracy of EUS-FNB was 94.2% (95% CI, 84.1-98.8). Two mild cases of pancreatitis (3.8%) occurred after EUS-FNB.
CONCLUSIONS: EUS-FNB using end-cutting needles enhanced the ICDC in >90% of patients, ruling out malignancy in focal presentations and defining the specific subtype of AIP. (Clinical trial registration number: NCT04397731.).