Evaluation of needle types in endoscopic ultrasound-guided tissue acquisition of pancreatic lesions for genetic yield and quality.

Abstract

Background and Aim: Precision medicine-the use of targeted chemotherapy for genetic subtypes-is becoming increasingly important. Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is the gold standard in tissue acquisition of pancreatic ductal adenocarcinoma (PDAC). The key to precision medicine is having it guided by the extraction of good-quality genetic material in adequate yields. There is a paucity of evidence on the use of particular needle types or sizes and their impact on genetic yield and quality. Method(s): Patients aged 18 years or older with a diagnosis of PDAC who underwent EUS-FNB between 2016 and 2021 were retrospectively identified from a single database. Genetic quantity was measured in micrograms, and quality was defined by RNA or DNA integrity number (RIN and DIN). FNB needles were categorized by size and type: Acquire 22 gauge, Procore 20 gauge, and Procore 22 gauge. Result(s): Of patients with a final diagnosis of PDAC, we identified 137 with DNA data and 145 with RNA data. Among these patients, Procore 20G was associated with higher RNA quantity (4125 mug; 2003.75-5954.75) (P = 0.012). There were no other significant differences between needles or quality of tissue acquired. Conclusion(s): The Procore 20G needle was associated with a higher quantity of RNA during EUS-FNB tissue acquisition. There were no differences in the quality of the genetic tissue acquired by the different needles.