Enhancing comprehensive genome profiling of liver tumors using endoscopic ultrasound-guided fine-needle biopsy

Comprehensive genome profiling (CGP) is gaining importance in management of biliary and pancreatic cancers; therefore, obtaining ideal tissue samples is critical. Although percutaneous biopsy has been the first-line method of sampling liver tumors, recent advances in endoscopic ultrasound (EUS)-guided tissue acquisition (EUS-TA), particularly introduction of fine-needle biopsy (FNB) needles capable of obtaining larger tissue samples, suggest that EUS-TA may be an alternative for obtaining ideal specimens for CGP. However, few studies have evaluated the utility of EUS-TA with CGP for liver tumors. This study aimed to assess the role of EUS-guided FNB (EUS-FNB) in collection of ideal liver tumor samples for CGP and analyses.

This retrospective study included 36 patients with liver tumors who underwent EUS-FNB. Histological diagnostic accuracy, rate of obtaining ideal samples for CGP, and impact of procedural factors, such as needle gauge, tumor size, and number of punctures, were analyzed.

EUS-TA achieved a histological diagnostic accuracy rate of 94.4%, and the rate of obtaining ideal samples for CGP was 63.9%. Subgroup analysis showed that 22G (70.4%) and 19G (100%) needles were significantly more effective than 25G needles (16.7%) for obtaining ideal samples for CGP ( P =0.025 and P =0.048, respectively). No adverse events were observed during or after sampling.

EUS-FNB is highly effective for obtaining ideal samples for CGP and achieving an accurate histological diagnosis. The 22G and 19G needles were significantly superior to 25G needles, thus emphasizing their importance in precision medicine.