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Meta-Analysis
. 2013 Jun 21;19(23):3678-84.
doi: 10.3748/wjg.v19.i23.3678.

Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: a systematic review and meta analysis

Srinivas R Puli  1 , Nikhil Kalva, Matthew L Bechtold, Smitha R Pamulaparthy, Micheal D Cashman, Norman C Estes, Richard H Pearl, Fritz-Henry Volmar, Sonu Dillon, Michael F Shekleton, David Forcione
Affiliations
Meta-Analysis

Diagnostic accuracy of endoscopic ultrasound in pancreatic neuroendocrine tumors: a systematic review and meta analysis

Srinivas R Puli et al. World J Gastroenterol. .

Abstract

Aim: To detect pancreatic neuroendocrine tumors (PNETs) has been varied. This study is undertaken to evaluate the accuracy of endoscopic ultrasound (EUS) in detecting PNETs.

Methods: Only EUS studies confirmed by surgery or appropriate follow-up were selected. Articles were searched in Medline, Ovid journals, Medline nonindexed citations, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Pooling was conducted by both fixed and random effects model).

Results: Initial search identified 2610 reference articles, of these 140 relevant articles were selected and reviewed. Data was extracted from 13 studies (n = 456) which met the inclusion criteria. Pooled sensitivity of EUS in detecting a PNETs was 87.2% (95%CI: 82.2-91.2). EUS had a pooled specificity of 98.0% (95%CI: 94.3-99.6). The positive likelihood ratio of EUS was 11.1 (95%CI: 5.34-22.8) and negative likelihood ratio was 0.17 (95%CI: 0.13-0.24). The diagnostic odds ratio, the odds of having anatomic PNETs in positive as compared to negative EUS studies was 94.7 (95%CI: 37.9-236.1). Begg-Mazumdar bias indicator for publication bias gave a Kendall's tau value of 0.31 (P = 0.16), indication no publication bias. The P for χ² heterogeneity for all the pooled accuracy estimates was > 0.10.

Conclusion: EUS has excellent sensitivity and specificity to detect PNETs. EUS should be strongly considered for evaluation of PNETs.

Keywords: Endoscopic ultrasound; Endosonography; Negative predictive value; Neuroendocrine tumors; Pancreatic mass; Positive predictive value; Sensitivity; Specificity; Ultrasound.

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Figures

Figure 1
Figure 1
Search results. EUS: Endoscopic ultrasound; PNETs: Pancreatic neuroendocrine tumors.
Figure 2
Figure 2
Forrest plot. A: Forrest plot showing sensitivity of endoscopic ultrasound (EUS) to detect pancreatic neuroendocrine tumor; B: Forrest plot showing specificity of EUS to detect pancreatic neuroendocrine tumors.
Figure 3
Figure 3
Summary receiver operating characteristic curves of endoscopic ultrasound to detect pancreatic neuroendocrine tumors. AUC: Area under the curve; SROC: Summary receiver operating characteristic.
Figure 4
Figure 4
Funnel plot showing no publication bias in the studies included in this meta-analysis.
See this image and copyright information in PMC

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