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

doi:10.16150/j.1671-2870.2025.05.004

Abstract

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

CLC Number:

R446.8
R576

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. 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[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(05): 498-504.

Figures/Tables 4

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Item	EUS-FNB （n=30）	EUS-FNA （n=27）	P value
Age（year）	65.47±1.91	64.15±1.20	0.77
Gender			0.29
Male	25	25
Female	5	2
Serum IgG₄（g/L）	8.39±1.39	6.77±1.06	0.24
Location of pancreatic swelling
Diffuse	21	15
Focal	9	12
Stenosis of pancreatic duct（%）	20	26	0.59
Atrophy of pancreatic duct（%）	3.3	11.1	0.25
Puncture needle type			<0.001
22G-Acquire	30	0
22G-EXPECT	0	17
22G-EchoTip Ultra	0	10
Number of punctures	2.6	2.8	0.62

Item	EUS-FNB	EUS-FNA
Number of diagnosed AIP patients before puncture	21	15
Number of suspected AIP patients before puncture	9	12
Number of level 1 of suspected AIP patients	1	0
Number of level 2 of suspected AIP patients	4	1