诊断学理论与实践

诊断学理论与实践 >

2025 , Vol. 24 >Issue 05: 498 - 504

DOI: https://doi.org/10.16150/j.1671-2870.2025.05.004

论著

Acquire穿刺活检针和细针穿刺抽吸针用于超声内镜引导下1型自身免疫性胰腺炎穿刺诊断效能的比较研究

  • 沈潇男 ,
  • 周春华 ,
  • 张本炎 ,
  • 高丽丽 ,
  • 张玲 ,
  • 何相宜 ,
  • 刘辰晓 ,
  • 张贤达 ,
  • 张尧 ,
  • 吴巍 ,
  • 龚婷婷 ,
  • 张天宇 ,
  • 刘磊 ,
  • 邹多武 ,
  • 张敏敏
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  • 上海交通大学医学院附属瑞金医院 a.消化内科，b.病理科，上海 200025
张敏敏 E-mail： Minminzhang2002@126.com

收稿日期: 2025-06-19

  修回日期: 2025-07-25

  录用日期: 2025-07-30

  网络出版日期: 2025-10-25

基金资助

国家自然科学基金面上项目(82270667)

收起

Comparative study on diagnostic performance of Acquire fine-needle biopsy and fine-needle aspiration in endoscopic ultrasonography-guided tissue acquisition for type 1 autoimmune pancreatitis

  • SHEN Xiaonan ,
  • ZHOU Chunhua ,
  • ZHANG Benyan ,
  • GAO Lili ,
  • ZHANG Ling ,
  • HE Xiangyi ,
  • LIU Chenxiao ,
  • ZHANG Xianda ,
  • ZHANG Yao ,
  • WU Wei ,
  • GONG Tingting ,
  • ZHANG Tianyu ,
  • LIU Lei ,
  • ZOU Duowu ,
  • ZHANG Minmin
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  • Department of Gastroenterology; b. Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2025-06-19

  Revised date: 2025-07-25

  Accepted date: 2025-07-30

  Online published: 2025-10-25

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摘要

目的： 比较22G-Acquire穿刺针穿刺活检（fine-needle biopsy，FNB）与22G-常规细针穿刺抽吸术（fine-needle aspiration，FNA）在1型自身免疫性胰腺炎（autoimmune pancreatitis，AIP）穿刺组织细胞学诊断中的应用价值。方法： 回顾性纳入2020年1月至2024年1月期间我院收治的57例经影像学、血清学高度疑诊为1型AIP的患者。根据患者所用穿刺针型号，分为FNB针组（22G-Acquire针组）（n=30）和FNA针组（n=27），评价超声内镜（endoscopic ultrasonography，EUS）引导下2种穿刺针所获取的1型AIP组织学诊断等级。结果： 在FNA组中，33.3%的穿刺组织存在淋巴浆细胞浸润，仅22.2%可见席纹状纤维化，组织学等级（Level）2证据等级占11.1%，而无Level 1证据。FNB组中63.3%穿刺组织存在淋巴浆细胞浸润，83.3%的穿刺组织可见席纹状纤维化，Level 1占比3.3%，Level 2占比56.7%，Level 1+2级共60%。2组中闭塞性静脉炎均未发现，IgG4阳性浆细胞>10个/高倍视野（high power field， HPF）共2例，FNB组及FNA组各1例。与FNA组相比，FNB组在所获组织中观察淋巴浆细胞浸润（63.3%比33.3%）（P=0.024）、席纹状纤维化（83.3%比22.2%）（P<0.001）均有较大优势，FNB组所获的证据等级更高（P<0.001）。结论： 22G-Acquire针可获得更高的组织证据等级，可常规用于1型AIP的组织学诊断。

关键词： 1型自身免疫性胰腺炎; 细针穿刺活检; 细针穿刺抽吸术; 组织病理学诊断

本文引用格式

沈潇男 , 周春华 , 张本炎 , 高丽丽 , 张玲 , 何相宜 , 刘辰晓 , 张贤达 , 张尧 , 吴巍 , 龚婷婷 , 张天宇 , 刘磊 , 邹多武 , 张敏敏 . Acquire穿刺活检针和细针穿刺抽吸针用于超声内镜引导下1型自身免疫性胰腺炎穿刺诊断效能的比较研究[J]. 诊断学理论与实践, 2025 , 24(05) : 498 -504 . DOI: 10.16150/j.1671-2870.2025.05.004

Abstract

Objective： To compare the application value of 22G-Acquire fine-needle biopsy (FNB) and conventional 22G fine-needle aspiration (FNA) in the cytological diagnosis of type 1 autoimmune pancreatitis (AIP). Methods： This retrospective study included 57 patients who were highly suspected of type 1 AIP based on imaging and serology and were admitted to our hospital from January 2020 to January 2024. According to the type of needle used, patients were divided into two groups: the FNB group (22G-Acquire needle, n=30) and the FNA group (n=27) to evaluate the histological diagnostic levels of type 1 AIP obtained by two needle types under endoscopic ultrasonography (EUS)-guided sampling. Results： In the FNA group, lymphoplasmacytic infiltration was observed in 33.3% of puncture tissues, while storiform fibrosis was identified in only 22.2%. Level 2 histological evidence was achieved in 11.1% of cases, with no Level 1 evidence. In the FNB group, lymphoplasmacytic infiltration was observed in 63.3% of puncture tissues, and storiform fibrosis was present in 83.3% of puncture tissues. Level 1 evidence was observed in 3.3% of cases, Level 2 in 56.7%, and combined Level 1+2 in 60%. Obliterative phlebitis was not detected in either group. Two cases met the criteria of IgG4-positive plasma cells >10 per high power field (HPF), with 1 case each in FNB group and FNA group. Compared to the FNA group, the FNB group showed significant advantages in the detection of lymphoplasmacytic infiltration (63.3% vs 33.3%) (P=0.024) and storiform fibrosis (83.3% vs 22.2%) (P<0.001) in the obtained tissues, along with higher evidence levels (P<0.001). Conclusion： The 22G-Acquire needle can obtain higher tissue evidence levels and can be routinely employed for the histological diagnosis of type 1 AIP.

Key words： Type 1 autoimmune pancreatitis; Fine-needle biopsy; Fine-needle aspiration; Histopathological diagnosis

参考文献

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