BACKGROUND Other than surgery, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the only procedure for histologically diagnosing autoimmune pancreatitis (AIP). However, adequate specimens are difficult to obtain. Recently, more adequate specimens were reported to be obtained with EUS-FNA with a wet suction technique (WEST) than with conventional EUS-FNA. AIM To histologically diagnose AIP by EUS-FNA with a WEST. METHODS Eleven patients with possible type 1 AIP between February 2016 and August 2018 underwent EUS-FNA with a WEST (WEST group), with four punctures by 19 or 22 G needles. As a historical control, 23 type 1 AIP patients who underwent no fewer than four punctures with 19 or 22 G needles were enrolled (DRY group). Patient characteristics and histological findings were compared between the two groups. RESULTS Three histopathological factors according to the International Consensus Diagnostic Criteria were significantly greater in the WEST group than the DRY group [lymphoplasmacytic infiltrate without granulocytic infiltration: 9 (81.8%) vs 6 (26.1%), P = 0.003, storiform fibrosis: 5 (45.5%) vs 1 (4.3%), P = 0.008, abundant (> 10 cells/HPF) IgG4-positive cells: 7 (63.6%) vs 5 (21.7%), P = 0.026]. Level 1 or level 2 histopathological findings were observed more often in the WEST group than in the DRY group [8 (72.7%) vs 3 (13.0%), P = 0.001]. CONCLUSION EUS-FNA with a WEST was more successful than standard EUS-FNA in histologically diagnosing AIP.

中文翻译：

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湿吸技术能否改变内镜超声引导下细针穿刺检查诊断自身免疫性胰腺炎1型的效力？前瞻性单臂研究。

背景技术除了手术以外，内镜超声引导下细针穿刺术（EUS-FNA）是组织学诊断自身免疫性胰腺炎（AIP）的唯一方法。但是，很难获得足够的样本。近来，据报道，采用湿吸技术（WEST）的EUS-FNA比传统的EUS-FNA能获得更多的标本。目的通过EUS-FNA对WEST进行组织学诊断。方法2016年2月至2018年8月期间，对11例可能发生1型AIP的患者进行了EUS-FNA的WEST（WEST组），用19或22 G针进行四次穿刺。作为历史对照，招募了23例经19或22 G针穿刺不少于4次的1型AIP患者（DRY组）。比较两组患者的特征和组织学发现。结果根据国际共识诊断标准，WEST组的三种组织病理学因素显着大于DRY组[无颗粒细胞浸润的淋巴浆细胞浸润：9（81.8％）vs 6（26.1％），P = 0.003，星形胶质纤维化：5（ 45.5％）vs. 1（4.3％），P = 0.008，大量（> 10个细胞/ HPF）IgG4阳性细胞：7（63.6％）vs 5（21.7％），P = 0.026]。与DRY组相比，在WEST组中观察到1级或2级组织病理学发现的频率更高[8（72.7％）vs 3（13.0％），P = 0.001]。结论带有WEST的EUS-FNA在组织学诊断AIP方面比标准EUS-FNA更成功。