Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Clinical utility of endoscopic ultrasound-guided tissue acquisition for comprehensive genomic profiling of pancreatic cancer

  • Nozomi Okuno (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Kazuo Hara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Nobumasa Mizuno (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Shin Haba (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takamichi Kuwahara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Yasuhiro Kuraishi (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Daiki Fumihara (Department of Gastroenterology, Aichi Cancer Center Hospital) ;
  • Takafumi Yanaidani (Department of Gastroenterology, Aichi Cancer Center Hospital)
  • Received : 2022.02.22
  • Accepted : 2022.06.30
  • Published : 2023.03.30
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Abstract

Background/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is essential for the diagnosis of pancreatic cancer. The feasibility of comprehensive genomic profiling (CGP) using samples obtained by EUS-TA has been under recent discussion. This study aimed to evaluate the utility of EUS-TA for CGP in a clinical setting. Methods: CGP was attempted in 178 samples obtained from 151 consecutive patients with pancreatic cancer at the Aichi Cancer Center between October 2019 and September 2021. We evaluated the adequacy of the samples for CGP and determined the factors associated with the adequacy of the samples obtained by EUS-TA retrospectively. Results: The overall adequacy for CGP was 65.2% (116/178), which was significantly different among the four sampling methods (EUS-TA vs. surgical specimen vs. percutaneous biopsy vs. duodenal biopsy, 56.0% [61/109] vs. 80.4% [41/51] vs. 76.5% [13/17] vs. 100.0% [1/1], respectively; p=0.022). In a univariate analysis, needle gauge/type was associated with adequacy (22 G fine-needle aspiration vs. 22 G fine-needle biopsy [FNB] vs. 19 G-FNB, 33.3% (5/15) vs. 53.5% (23/43) vs. 72.5% (29/40); p=0.022). The sample adequacy of 19 G-FNB for CGP was 72.5% (29/40), and there was no significant difference between 19 G-FNB and surgical specimens (p=0.375). Conclusions: To obtain adequate samples for CGP with EUS-TA, 19 G-FNB was shown to be the best in clinical practice. However, 19 G-FNB was not still sufficient, so further efforts are required to improve adequacy for CGP.

Keywords

References

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