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Meta-Analysis
. 2016 Mar 10:6:22978.
doi: 10.1038/srep22978.

Endoscopic ultrasound-guided fine needle core biopsy for the diagnosis of pancreatic malignant lesions: a systematic review and Meta-Analysis

Yongtao Yang  1 , Lianyong Li  1 , Changmin Qu  1 , Shuwen Liang  1 , Bolun Zeng  1 , Zhiwen Luo  1
Affiliations
Meta-Analysis

Endoscopic ultrasound-guided fine needle core biopsy for the diagnosis of pancreatic malignant lesions: a systematic review and Meta-Analysis

Yongtao Yang et al. Sci Rep. .

Abstract

Endoscopic ultrasound-guided fine needle core biopsy (EUS-FNB) has been used as an effective method of diagnosing pancreatic malignant lesions. It has the advantage of providing well preserved tissue for histologic grading and subsequent molecular biological analysis. In order to estimate the diagnostic accuracy of EUS-FNB for pancreatic malignant lesions, studies assessing EUS-FNB to diagnose solid pancreatic masses were selected via Medline. Sixteen articles published between 2005 and 2015, covering 828 patients, met the inclusion criteria. The summary estimates for EUS-FNB differentiating malignant from benign solid pancreatic masses were: sensitivity 0.84 (95% confidence interval (CI), 0.82-0.87); specificity 0.98 (95% CI, 0.93-1.00); positive likelihood ratio 8.0 (95% CI 4.5-14.4); negative likelihood ratio 0.17 (95% CI 0.10-0.26); and DOR 64 (95% CI 30.4-134.8). The area under the sROC curve was 0.96. Subgroup analysis did not identify other factors that could substantially affect the diagnostic accuracy, such as the study design, location of study, number of centers, location of lesion, whether or not a cytopathologist was present, and so on. EUS-FNB is a reliable diagnostic tool for solid pancreatic masses and should be especially considered for pathology where histologic morphology is preferred for diagnosis.

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Figures

Figure 1
Figure 1. Flow chart of the study selection process for eligible studies in the systematic review.
EUS, endoscopic ultrasound; FNA, fine needle aspiration; FNB, fine needle biopsy.
Figure 2
Figure 2. Forest plot of sensitivity and specificity estimates for EUS-FNB in the diagnosis of malignant pancreatic lesions.
The point estimates of sensitivity and specificity from each study are shown as solid circles. Error bars indicate 95% CIs. EUS-FNB, endoscopic ultrasound-guided fine needle core biopsy; CI, confidence interval.
Figure 3
Figure 3. Summary receiver operating characteristic curves summarize the overall diagnostic accuracy of EUS-FNB in diagnosis of malignant solid pancreatic masses.
EUS-FNB, endoscopic ultrasound-guided fine needle core biopsy.
Figure 4
Figure 4. Funnel graph for the evaluation of potential publication bias of selected studies.
Symbol size for each study is proportional to the study size. The line in the center indicates the summary DOR.The Egger test for publication bias was not significant.
See this image and copyright information in PMC

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