Comparison of 19-gauge FNA and 22-gauge FNB needles for the EUS-guided fine-needle aspiration of the lymphadenopathy and malignant lymphoma diagnosis: A multicenter retrospective study

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Background and Objectives: EUS-guided fine-needle aspiration (EUS-FNA) using a 19-gauge FNA needle can safely obtain sufficient tissue samples for the evaluation of lymphadenopathy. FNB needles can also provide adequate tissue, and 22-gauge needles are generally easier to puncture than 19-gauge needles. This study aimed to compare the diagnostic performance of 19-gauge FNA and 22-gauge FNB needles for the diagnosis of lymphadenopathy. Methods: Among the 411 patients with lymphadenopathy, 221 underwent an EUS-FNA procedure using 19-gauge FNA or 22-gauge FNB needles. Patient characteristics, puncture procedures, and the accuracy of the cytological and histological diagnoses of lymphadenopathy were analyzed. Results: There were 116 and 105 patients in the 19-gauge FNA and 22-gauge FNB groups, respectively. The median lymph node size was significantly larger in the 19-gauge FNA group (29 mm vs. 23 mm, P < 0.01). Cytological and histological accuracies were significantly higher in the 19-gauge FNA group (91% vs. 63%, P < 0.01; 93% vs. 82%, P = 0.01). Multivariate logistic regression analysis showed that the use of 19-gauge FNA was significantly associated with diagnostic accuracy (cytology: odds ratio = 5.72, P < 0.01; histology: odds ratio = 3.38, P < 0.01). For malignant lymphoma diagnosis, immunohistochemical evaluation rates were similar between groups, whereas flow cytometry and cytogenetic sensitivities were significantly higher with 19-gauge FNA (90% vs . 55%, P < 0.01; and 68% vs. 14%, P < 0.01). Post-puncture infection was observed in only 1 patient in the 19-gauge FNA group. Conclusion: The use of 19-gauge FNA needles appeared to be a good option for diagnosing lymphadenopathy, considering that no significant difference was observed in the occurrence of adverse events.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.