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Meta-Analysis
. 2017 Feb;96(5):e5802.
doi: 10.1097/MD.0000000000005802.

Comparison of two different size needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing solid pancreatic lesions: A meta-analysis of prospective controlled trials

Mei-Mei Xu  1 , Hong-Yu Jia, Li-Li Yan, Shan-Shan Li, Yue Zheng
Affiliations
Meta-Analysis

Comparison of two different size needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing solid pancreatic lesions: A meta-analysis of prospective controlled trials

Mei-Mei Xu et al. Medicine (Baltimore). 2017 Feb.

Abstract

Background: This meta-analysis aimed to provide a pooled analysis of prospective controlled trials comparing the diagnostic accuracy of 22-G and 25-G needles on endoscopic ultrasonography (EUS-FNA) of the solid pancreatic mass.

Methods: We established a rigorous study protocol according to Cochrane Collaboration recommendations. We systematically searched the PubMed and Embase databases to identify articles to include in the meta-analysis. Sensitivity, specificity, and corresponding 95% confidence intervals were calculated for 22-G and 25-G needles of individual studies from the contingency tables.

Results: Eleven prospective controlled trials included a total of 837 patients (412 with 22-G vs 425 with 25-G). Our outcomes revealed that 25-G needles (92% [95% CI, 89%-95%]) have higher sensitivity than 22-G needles (88% [95% CI, 84%-91%]) on solid pancreatic mass EUS-FNA (P = 0.046). However, there were no significant differences between the 2 groups in overall diagnostic specificity (P = 0.842). The pooled positive and negative likelihood ratio of the 22-G needle were 12.61 (95% CI, 5.65-28.14) and 0.16 (95% CI, 0.12-0.21), respectively. The pooled positive likelihood ratio was 12.61 (95% CI, 5.65-28.14), and the negative likelihood ratio was 0.16 (95% CI, 0.12-0.21) for the 22-G needle. The pooled positive likelihood ratio was 8.44 (95% CI, 3.87-18.42), and the negative likelihood ratio was 0.13 (95% CI, 0.09-0.18) for the 25-G needle. The area under the summary receiver operating characteristic curve was 0.97 for the 22-G needle and 0.96 for the 25-G needle.

Conclusion: Compared to the study of 22-G EUS-FNA needles, our study showed that 25-G needles have superior sensitivity in the evaluation of solid pancreatic lesions by EUS-FNA.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flowchart of the study selection process for eligible studies in the systematic review.
Figure 2
Figure 2
Results for the 22-gauge needle in individual studies and from pooled data shown as forest plots for: (A) sensitivity and (B) specificity.
Figure 3
Figure 3
Results for the 25-gauge needle in individual studies and from pooled data shown as forest plots for: (A) sensitivity and (B) specificity.
Figure 4
Figure 4
The pooled positive and negative likelihood ratios for solid pancreatic mass fine-needle aspiration guided by endoscopic ultrasonography for: (A) PLR for 22-gauge needle; (B) NLR for 22-gauge; (C) PLR for 25-gauge needles; (D) NLR for 25-gauge. NLR = negative likelihood ratios, PLR = positive likelihood ratios.
Figure 5
Figure 5
Summary receiver operating characteristic curves summarize the overall diagnostic accuracy for solid pancreatic mass fine-needle aspiration guided by endoscopic ultrasonography: (A) 22-gauge needles and (B) 25-gauge needles.
See this image and copyright information in PMC

References

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