Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 22;11(9):e0163056.
doi: 10.1371/journal.pone.0163056. eCollection 2016.

Rapid On-Site Evaluation Does Not Improve Endoscopic Ultrasound-Guided Fine Needle Aspiration Adequacy in Pancreatic Masses: A Meta-Analysis and Systematic Review

Fanyang Kong  1 , Jianwei Zhu  1 , Xiangyu Kong  1 , Tao Sun  1 , Xuan Deng  2 , Yiqi Du  1 , Zhaoshen Li  1
Affiliations

Rapid On-Site Evaluation Does Not Improve Endoscopic Ultrasound-Guided Fine Needle Aspiration Adequacy in Pancreatic Masses: A Meta-Analysis and Systematic Review

Fanyang Kong et al. PLoS One. .

Abstract

Background and objectives: Rapid on-site evaluation (ROSE) during endoscopic ultrasonography-guided fine needle aspiration (EUS-FNA) of pancreatic masses has been reported to be associated with improved adequacy and diagnostic yield. However, recent observational data on the impact of ROSE have reported conflicting results. A meta-analysis and systematic review was therefore conducted to evaluate the contribution of ROSE during EUS-FNA of pancreatic masses.

Method: A systematic search was conducted in MEDLINE/Pubmed and EMBASE databases for studies comparing the efficacy of ROSE between patients in two cohorts. Outcomes considered included diagnostic adequate rate, diagnostic yield, number of needle passes, pooled sensitivity and specificity. Findings from a random-effects model were expressed as pooled risk difference (RD) with 95% confidence intervals (CIs).

Results: A total of 7 studies (1299 patients) was finally included and further analyzed in the current meta-analysis. EUS-FNA with ROSE could not improve diagnostic adequacy (RD = 0.05, 95% CI: -0.01-0.11) and diagnostic yield (RD = 0.04 95%CI: -0.05, 0.13). The number of needle passes showed no statistically significant difference with and without ROSE (RD = -0.68 95%CI: -2.35, 0.98). The pooled sensitivity and specificity of ROSE group were 0.91 (95%CI: 0.87, 0.94) and 1 (95%CI: 0.94, 1.00). The pooled sensitivity and specificity of non-ROSE group were 0.85 (95%CI: 0.80, 0.89) and 1 (95%CI: 0.95, 1.00). ROSE group and non-ROSE group showed comparable sensitivity and specificity.

Conclusion: Compared to historical reports of its clinical efficacy in patients with pancreatic lesions, ROSE may be not associated with an improvement of diagnostic yield, adequate rate, pooled sensitivity and specificity.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart of literature search and selection.
Fig 2
Fig 2. Forest plot displaying the Risk Difference and 95% CIs of each study for the adequacy rate.
Fig 3
Fig 3. Forest plot displaying the impact of assessor type to adequacy rate.
Fig 4
Fig 4. Forest plot displaying the Risk Difference and 95% CIs of each study for the diagnosis yield.
Fig 5
Fig 5. Forest plot displaying the Risk Difference and 95% CIs of each study for the diagnosis yield of malignancy.
Fig 6
Fig 6
Results for the ROSE group in individual studies and from pooled data shown as forest plots for: a sensitivity; b specificity. The I2 result for heterogeneity is also stated (CI, confidence interval; df, degrees of freedom).
Fig 7
Fig 7
Results for the non-ROSE group in individual studies and from pooled data shown as forest plots for: a sensitivity; b specificity. The I2 result for heterogeneity is also stated (CI, confidence interval; df, degrees of freedom).
Fig 8
Fig 8. Weighted summary receiver operating characteristic (SROC) curve, with 95% confidence interval (CI), for studies involved.
a ROSE group; b non-ROSE group.
See this image and copyright information in PMC

References

    1. Vincent A, Herman J, Schulick R, Hruban RH, Goggins M (2011) Pancreatic cancer. Lancet 378: 607–620. 10.1016/S0140-6736(10)62307-0 - DOI - PMC - PubMed
    1. Ryan DP, Hong TS, Bardeesy N (2014) Pancreatic adenocarcinoma. N Engl J Med 371: 1039–1049. 10.1056/NEJMra1404198 - DOI - PubMed
    1. Erickson RA (2004) EUS-guided FNA. Gastrointest Endosc 60: 267–279. - PubMed
    1. Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM (1997) Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology 112: 1087–1095. - PubMed
    1. Harewood GC, Wiersema MJ, Nelson H, Maccarty RL, Olson JE, Clain JE, et al. (2002) A prospective, blinded assessment of the impact of preoperative staging on the management of rectal cancer. Gastroenterology 123: 24–32. - PubMed

LinkOut - more resources