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EUS-guided tissue sampling with a 20-gauge core biopsy needle for the characterization of gastrointestinal subepithelial lesions: A multicenter study

1 Unit of Gastroenterology and Digestive Endoscopy, Augusto Murri Hospital, Fermo, Italy
2 Diagnostic and Therapeutic Endoscopy Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
3 Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, Bologna, Italy
4 Unit of Gastroenterology and Digestive Endoscopy, ASST Rhodense, Garbagnate Milanese  (MI), Italy
5 Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy
6 Division of Gastroenterology, Azienda Ospedaliero Universitaria “Maggiore della Carità”, Novara, Italy

Correspondence Address:
Filippo Antonini,
UOC Gastroenterologia ed Endoscopia Digestiva, Università Politecnica delle Marche, Ospedale “A. Murri”, Fermo - 63900
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eus.eus_1_18

PMID: 29770781

Background and Objective: A new 20-gauge (G) biopsy needle with a core-trap technology has been developed with a large core size and enhanced flexibility. The aim of this multicenter study was to determine the feasibility, efficacy, and safety of EUS-guided fine-needle biopsy (EUS-FNB) with the new 20G needle in diagnosing subepithelial lesions (SELs). Materials and Methods: Retrospectively collected data from consecutive patients with SELs undergoing EUS-FNB with the 20G needle at five centers were analyzed. Results: A total of 50 SELs were included. The mean lesion size was 43.1 ± 17.5 mm. The lesion locations were esophagus (n = 1), stomach (n = 37), distal duodenum (n = 5), rectum (n = 6), and colon (n = 1). The procedure was technically feasible in all patients. Definitive diagnosis with full histological assessment including immunohistochemistry was obtained in 88% (44/50) of the patients. Considering malignant versus benign lesions, the sensitivity, specificity, positive predictive value, and negative predictive value were 85% (95% confidence interval [CI] 70.2–94.3), 100% (95% CI 58.7%–100%), 100% (95% CI 85.1%–100%), and 62.5 (95% CI 27.7–84.8), respectively. No major complications requiring additional care have been observed. Conclusions: In this multicenter study, we found that EUS-FNB with the new 20G core needle is an effective and safe method for the diagnosis of SELs with a high rate of producing adequate histological material and high diagnostic accuracy even from difficult-to-approach anatomical locations.

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