Background and Aims: There is limited literature on sample adequacy for molecular testing in pancreatic ductal adenocarcinoma obtained via endoscopic ultrasound (EUS) fine-needle aspiration (FNA) versus EUS fine-needle biopsy (FNB). We aimed to compare these two modalities regarding sample adequacy for molecular and genomic sequencing. Methods: We reviewed all patients with pancreatic ductal adenocarcinoma who underwent EUS at Saint Luke’s Hospital from 2018 to 2021. The patients were categorized based on the method of EUS tissue acquisition, specifically FNA or FNB. A comprehensive evaluation was conducted for all cases by cytotechnologists. Results: Out of 132 patients who underwent EUS-guided biopsies, 76 opted for FNA, 48 opted for FNB, and 8 opted for a combination of both. The average number of passes required for FNB and FNA was 2.58 ± 1.06 and 2.49 ± 1.07, respectively (p= 0.704), indicating no significant difference. Interestingly, 71.4% (35) of FNB-obtained samples were deemed adequate for molecular testing, surpassing the 32.1% (26) adequacy observed with FNA (p< 0.001). Additionally, 46.4% (26) of FNB-obtained samples were considered adequate for genomic testing, a notable improvement over the 23.8% (20) adequacy observed with FNA (p= 0.005). Conclusion: Although the number of passes required for cytologic diagnosis did not differ significantly between EUS-FNB and EUS-FNA, the former demonstrated superiority in obtaining samples adequate for molecular testing. Tumor surface area and cellularity were crucial parameters in determining sample adequacy for molecular testing, irrespective of the chosen tissue acquisition modality.
背景与目的：目前关于内镜超声引导下细针穿刺抽吸术与内镜超声引导下细针活检术获取的胰腺导管腺癌样本在分子检测适用性方面的文献较为有限。本研究旨在比较这两种取样方式在分子及基因组测序样本适用性方面的差异。方法：我们回顾性分析了2018年至2021年在圣卢克医院接受内镜超声检查的所有胰腺导管腺癌患者。根据取样方式（细针穿刺抽吸术或细针活检术）对患者进行分类，所有病例均由细胞学技术人员进行全面评估。结果：在132例接受内镜超声引导活检的患者中，76例选择细针穿刺抽吸术，48例选择细针活检术，8例选择联合取样。细针活检术与细针穿刺抽吸术的平均穿刺次数分别为2.58±1.06次和2.49±1.07次（p=0.704），无显著差异。值得注意的是，细针活检术获取的样本中71.4%（35例）适用于分子检测，显著高于细针穿刺抽吸术的32.1%（26例）（p<0.001）。此外，细针活检术样本中46.4%（26例）适用于基因组检测，较细针穿刺抽吸术的23.8%（20例）有明显提升（p=0.005）。结论：尽管内镜超声引导下细针活检术与细针穿刺抽吸术在细胞学诊断所需穿刺次数上无显著差异，但前者在获取适用于分子检测的样本方面更具优势。无论采用何种取样方式，肿瘤表面积与细胞密度均是决定样本分子检测适用性的关键参数。
肿瘤(癌症)患者之家