Introduction:

Cytology by fine needle aspiration guided by endoscopic ultrasound (FNAC-EUS) is a technique recommended for the tissue diagnosis of pancreatic tumors; Different diameters of needles have been used for FNAC-EUS (19, 22 and 25 gauges). It has been argued that the ability of the procedure to reliably provide a histological diagnosis has to do with factors such as the type of needle, the size of the needle, the number of passes that are made during the procedure and the availability of a cytopathologist who is present in the room during the study.

Aim:

The primary aim of our study was to evaluate in a comparative way the diagnostic performance of the No ProCore (FNA) vs ProCore (FNB) needles of calibers 22 and 25 G for the diagnosis of solid tumors of the pancreas.

Material and methods:

A prospective, analytical study was conducted of all the samples performed by EUS in the Gastrointestinal Endoscopy Unit of the National Institute of Cancerology, between February 2017 and January 2019. Men and women over 18 years were included. Patients with anatomical alterations secondary to surgery of the upper digestive tract and those with coagulation abnormalities was excluded. The patients were randomized to 4 groups of patients to whom EUS was performed with 4 different types of needles. Wasnt a cytopathologist in the room. In order to report the results, the criteria of the papanicolaou society was used to classify the sample as adequate, inadequate or insufficient. The pathologist determined whether the sample was suitable for cell block realization. The present study was analyzed by means of descriptive statistics: frequencies, percentages to describe qualitative variables. We develop normality tests for quantitative variables; its expression in mean and standard deviation. Chi square was used to analyze frequencies or proportions with the statistical package SSPS version 25.0 for the analysis of the data. The analysis of each of the needles was developed, using 2 x 2 tables to determine sensitivity, specificity, positive predictive value and negative predictive value and diagnostic accuracy. We calculate Fisher’s Chi square. Statistical significance was determined with a P value of <0.05.

Results:

131 patients was included. Patients were distributed according to the needle that was used as follows: Group A) 36 patients with FNAC-EUS with 22G ProCore needles, Group B) 33 patients with 22G No ProCore needle, Group C) 22 patients with 25G ProCore needle and Group D) 40 patients with 25G No ProCore needle. The most frequent histology was adenocarcinoma in 58.0%, followed by metastasis in 24.4 (p = 0.93). When comparing the groups of the four types of needle, against our final outcome, which was to identify the diagnostic and non-diagnostic groups, no statistical significance was observed (p = 0.57), no statistical significance observed when comparing adequate, inadequate or insufficient cytology among the four types of needles (p = 0.38). The sensitivity, specificity, PPV and NPV of group A were 88%, 75%, 97%, 25%; from group B, 85%, 100%, 100%, 37%; of group C, 87%, 100%, 100%, 25%; of group D, 85%, 100%, 100%, 50%, respectively. No technical failures derived procedure, nor complications.

Conclusions:

Punctures through endoscopic ultrasound of solid pancreatic tumors can be performed interchangeably with ProCore and Non ProCore needles, since they have been shown to be effective and safe.

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