Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Can the wet suction technique change the efficacy of endoscopic ultrasound-guided fine-needle aspiration for diagnosing autoimmune pancreatitis type 1? A prospective single-arm study
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Takuto Hikichi, Kenji Notohara, Hiromasa Ohira
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Ko Watanabe, Jun Nakamura, Hitomi Kikuchi, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Hiromasa Ohira, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 960-1295, Japan
Ko Watanabe, Jun Nakamura, Minami Hashimoto, Takuto Hikichi, Department of Endoscopy, Fukushima Medical University Hospital, Fukushima 960-1295, Japan
Kenji Notohara, Department of Anatomic Pathology, Kurashiki Central Hospital, Kurashiki 710-8602, Japan
Author contributions: Sugimoto M wrote the paper and designed and performed the research and laboratory analyses; Takagi T wrote the paper and designed and oversaw the research; Suzuki R, Konno N, Asama H, Hikichi T, Watanabe K, Nakamura J, Kikuchi H, Takasumi M, Sato Y, Irie H, Hashimoto M and Kato T provided clinical advice; Hikichi T supervised the report; Notohara K performed the pathological diagnoses; and Ohira H supervised the report and the writing of the paper. All authors have read and approved the manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of Fukushima Medical University.
Clinical trial registration statement: The clinical trial was registered in UMIN (ID: 000019768).
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrollment.
Conflict-of-interest statement: The authors of this manuscript having no conflicts of interest to disclose.
Data sharing statement: There is no additional data available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Tadayuki Takagi, MD, PhD, Assistant Professor, Doctor, Department of Gastroenterology, Fukushima Medical University, School of Medicine, Hikarigaoka 1, Fukushima 960-1295, Japan. daccho@fmu.ac.jp
Received: October 17, 2019
Peer-review started: October 17, 2019
First decision: November 9, 2019
Revised: November 27, 2019
Accepted: December 22, 2019
Article in press: December 22, 2019
Published online: January 6, 2020
ARTICLE HIGHLIGHTS
Research background
Apart from surgical biopsy, endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the only method used to histologically diagnose autoimmune pancreatitis (AIP) type 1. Nevertheless, it is very difficult to obtain an adequate specimen by EUS-FNA for a histological diagnosis of AIP type 1. However, recently, with EUS-FNA with a wet suction technique (WEST), adequate specimens were reported to be obtained more often than those obtained by conventional EUS-FNA.
Research motivation
EUS-FNA with a WEST could overcome the difficulty of histologically diagnosing AIP type 1.
Research objectives
To investigate the efficacy of EUS-FNA with a WEST for diagnosing AIP type 1.
Research methods
Eleven AIP type 1 patients were recruited for this study and underwent EUS-FNA with a WEST for histological diagnosis. The histological diagnosability was compared between the WEST group and a historical control group that included AIP type 1 patients who underwent conventional EUS-FNA before this study (DRY group).
Research results
Three histopathological features [lymphoplasmacytic infiltrate without granulocytic infiltration, storiform fibrosis, and abundant (>10 cells/HPF) IgG4-positive cells] according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than in the DRY group. Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group.
Research conclusions
EUS-FNA with a WEST was more useful than standard EUS-FNA in the histological diagnosis of AIP.
Research perspectives
The histological diagnosability of EUS-FNA for AIP will be developed by the improvement of puncture needles and puncture methods, such as WEST.
