Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

Table 1 Patients’ demographics and baseline characteristics

Parameter	Value
No. of patients	40
Age (yr), mean (SD)	67.2 (13.8)
Sex, n (%)
Male	18 (45)
Female	22 (55)
BMI (kg/m2)	24.3 (5.1)
Presenting symtom(s), n (%)
Pain	15 (37.5)
Weight loss	23 (57.5)
Jaundice	9 (22.5)
Anorexia	16 (40)
Propofol sedation dose (mg)1, mean (SD)	436 (201)
Examination prior to EUS
Abdominal ultrasound	3 (7.5)
CT	25 (62.5)
MRI	9 (22.5)
PET/CT	3 (7.5)

¹Data available in 36/40 patients. BMI: Body mass index; EUS: Endoscopic ultrasonography; SD: Standard deviation; CT: Computed tomography; MRI: Magnetic resonance imaging; PET/CT: Positron emission tomography/computed tomography.

Table 2 Lesion characteristics

Parameter	Value
Location in pancreas, n (%)
Head	27 (67.5)
Body	8 (20)
Tail	5 (12.5)
Size max (mm), mean (SD)	31.5 (12.3)
Echogenicity on EUS, n (%)
Hypoechoic	34 (85)
Isoechoic	3 (7.5)
Hyperechoic	0
Non-homogeneous	3 (7.5)
Final diagnosis, n (%)
Pancreatic adenocarcinoma	23 (57.5)
Pancreatic metastases1	6 (15)
Chronic pancreatitis	3 (7.5)
Serous cystic neoplasm/serous cystadenoma	2 (5)
Pancreatic NET	1 (2.5)
Lymphoma	1 (2.5)
Solid pseudopapillary neoplasm	1 (2.5)
Acinar cell carcinoma	1 (2.5)
Mucinous cystic neoplasm	1 (2.5)
Intrapancreatic accessory spleen	1 (2.5)
Gold standard method, n (%)
Definite EUS-FNB	21 (52.5)
Definite EUS-FNB + surgery	5 (12.5)
Surgery	8 (20)
Clinical follow up	6 (15)

¹Ileum-NET (n = 2), lung cancer (n = 2), renal cell carcinoma (n = 1), paraganglioma (n = 1). EUS-FNB: Endoscopic ultrasound-guided fine needle biopsy; NET: Neuroendocrine tumour.

Table 3 Technical characteristics and outcomes of endoscopic ultrasound-fine needle biopsies

Parameter	Value
Needle passes/patient, n (%)	2 (100)
Acquired histology, n (%)	40 (100)
Immunhistochemistry, n (%)	12 (30)
Histologic quality (Payne score), n (%)
Score 0 (needle pass 1/needle pass 2/overall)	1 (2.5)/1 (2.5)/1 (2.5)
Score 1 (needle pass 1/needle pass 2/overall)	2 (5)/3 (7.5)/1 (2.5)
Score 2 (needle pass 1/needle pass 2/overall)	3 (7.5)/3 (7.5)/1 (2,5)
Score 3 (needle pass 1/needle pass 2/overall)	34 (85)/33 (82.5)/37 (92.5)
Histologic quality, median (range)	2.85 (0-3)
Acquired high quality histology1, n (%)
Needle pass 1/needle pass 2/overall	34 (85)/33 (82.5)/37 (92.5)
Length of the biopsy cylinder (mm), mean (SD)
Needle pass 1/needle pass 2/overall	1.56 (0.9)/1.5 (0.9)/1.54 (0.9)
Diameter of the biopsy cylinder (mm), mean (SD)
Needle pass 1/needle pass 2/overall	0.41 (0.1)/0.38 (0.1)/0.39 (0.1)
Diagnostic accuracy	85%2/89.2%3
Sensitivity	78%
Specificity	100%
Positive predictive value	100%
Negative predictive value	53%
Complications, n (%)	1 (2.5)4

¹Defined as Payne score 3.

²In all patients (n = 40).

³In patients with an available high quality (Payne score 3) histological specimen (n = 37).

⁴self-limiting bleeding at puncture site.