EUS-guided reverse bevel fine-needle biopsy sampling and open tip fine-needle aspiration in solid pancreatic lesions – a prospective, comparative study

<p><b>Objectives:</b> Different diagnostic entities can present as solid pancreatic lesions (SPL). This study aimed to explore the utility of endoscopic ultrasound-guided reverse bevel fine-needle biopsy sampling (EUS-FNB) in SPLs.</p> <p><b>Material and methods:</b> In 2012–2015, consecutive patients with SPLs were prospectively included in a tertiary center setting and subjected to dual needle sampling with a 22 gauge reverse bevel biopsy needle and a conventional 25 gauge open tip aspiration needle (EUS-FNA). The outcome measures were the diagnostic accuracy of sampling, calculated for each modality separately and for the modalities combined (EUS-FNA + FNB), and the adverse event rate related to sampling.</p> <p><b>Results:</b> In 68 unique study subjects, the most common diagnostic entities were pancreatic neuroendocrine tumor, PNET, (34%), pancreatic ductal adenocarcinoma, PDAC, (32%), pancreatitis (15%) and metastasis (6%). The overall diagnostic accuracy of EUS-FNB was not significantly different from that of EUS-FNA, (69% vs. 78%, <i>p</i> = .31). EUS-FNA + FNB, compared with EUS-FNA alone, had a higher sensitivity for tumors other than PDAC (89% vs. 69%, <i>p</i> = .02) but not for PDACs (95% vs. 85%, <i>p</i> = .5). No adverse event was recorded after the study dual-needle sampling procedures.</p> <p><b>Conclusions:</b> Endoscopic ultrasound-guided tissue acquisition performed with a 22 gauge reverse bevel biopsy needle is safe but not superior to conventional fine-needle aspiration performed with a 25 gauge open tip needle in diagnosing solid pancreatic lesions. However, the performance of both these modalities may facilitate the diagnostic work-up in selected patients, such as cases suspicious for pancreatic neuroendocrine tumors and metastases. NCT02360839.</p

Additional file 1: Table S1. of Hedgehog inhibitor sonidegib potentiates 177Lu-octreotate therapy of GOT1 human small intestine neuroendocrine tumors in nude mice

Regulation patterns for the 96 transcripts regulated both after 177Lu-octreotate monotherapy and after combination therapy with sonidegib and 177Lu-octreotate. (XLS 40 kb

The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response-5

G FET expression against beta actin expression in each sample and by further comparing RA treated with untreated cells at each time point. Data from one of two independent experiments yielding similar results.<p><b>Copyright information:</b></p><p>Taken from "The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response"</p><p>http://www.biomedcentral.com/1471-2121/9/37</p><p>BMC Cell Biology 2008;9():37-37.</p><p>Published online 11 Jul 2008</p><p>PMCID:PMC2478660.</p><p></p

Top differentially expressed genes between superficial and intermediate/deep zones of articular cartilage.

<p>*SZ, superficial zone; IDZ, intermediate/deep zone.</p

The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response-7

SC – serous cells.<p><b>Copyright information:</b></p><p>Taken from "The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response"</p><p>http://www.biomedcentral.com/1471-2121/9/37</p><p>BMC Cell Biology 2008;9():37-37.</p><p>Published online 11 Jul 2008</p><p>PMCID:PMC2478660.</p><p></p

Real-time PCR of spatially upregulated genes that overlap between articular and growth plate cartilage zones.

<p>Relative expression of selected genes that overlap between RZ and IDZ, including <i>Bmp3</i>, <i>Grem1</i>, and <i>Sfrp5</i> (<b>D–F</b>), PZ and SZ, including <i>Gdf10</i>, <i>Prelp</i>, and <i>Olfml3</i> (<b>G–I</b>), as well as HZ and SZ, including <i>Adamts1</i>, <i>Mmp13</i>, and <i>Mmp9</i> (<b>J–L</b>), was determined in proximal tibial epiphyses of 10-day-old rats (n = 4) and values were normalized to 18S rRNA. Accuracy of the microdissection technique was validated by inspecting relative expression of <i>Prg4</i>, <i>Col10a1</i>, and <i>Alpl</i> (<b>A–C</b>). SZ, superficial zone; IDZ, intermediate/deep zone; RZ, resting zone; PZ, proliferative zone; HZ, hypertrophic zone; N.S., not significant; *<i>P</i><0.05; **<i>P</i><0.01; ***<i>P</i><0.001.</p

Number of spatially upregulated genes that overlap between articular and growth plate cartilage zones.

<p>Pearson’s chi-square test was used to determine whether an overlap is statistically significant. Significance indicates that an overlap is more or less than expected by chance, whereas non-significance indicates that an overlap is what would be expected by chance. Based on overlaps, SZ is more similar to HZ than other growth plate cartilage zones (<b>b, d–f</b>) and more similar to PZ than RZ (<b>a, c</b>), whereas IDZ is more similar to RZ than other growth plate cartilage zones (<b>g–i, k</b>) and has similarities to both PZ and HZ (<b>j, l</b>). SZ, superficial zone; IDZ, intermediate/deep zone; RZ, resting zone; PZ, proliferative zone; HZ, hypertrophic zone; N.S., not significant.</p

The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response-4

Ity in FET expression levels. FET expression is elevated in proliferating endometrium (upper panel) compared to differentiated secretory endometrium (lower panel).<p><b>Copyright information:</b></p><p>Taken from "The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response"</p><p>http://www.biomedcentral.com/1471-2121/9/37</p><p>BMC Cell Biology 2008;9():37-37.</p><p>Published online 11 Jul 2008</p><p>PMCID:PMC2478660.</p><p></p

Top differentially expressed genes between intermediate/deep zone of articular cartilage and resting zone of growth plate cartilage.

<p>*IDZ, intermediate/deep zone; RZ, resting zone.</p

The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response-6

Selected mRNAs in samples from inner or peripheral parts of colonies analyzed by quantitative real-time PCR with as endogenous control. – pluripotency marker,– ectodermal marker, – mesodermal marker,– proliferation marker. The day 12 measurement consists of one sample taken from inseparable, mixed cell populations. Undifferentiated hESCs show positive FET protein staining. Cells were stained with primary antibodies for FET proteins and visualized with Cy3-conjugated secondary antibodies (red). The merge images additionally show DAPI staining of nuclei (blue).<p><b>Copyright information:</b></p><p>Taken from "The multifunctional FUS, EWS and TAF15 proto-oncoproteins show cell type-specific expression patterns and involvement in cell spreading and stress response"</p><p>http://www.biomedcentral.com/1471-2121/9/37</p><p>BMC Cell Biology 2008;9():37-37.</p><p>Published online 11 Jul 2008</p><p>PMCID:PMC2478660.</p><p></p