Is there a difference between 19G core biopsy needle and 22G core biopsy needle in diagnosing the correct etiology?——A meta-analysis and systematic review
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摘要
AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovid journals. Pooling was conducted by both fixed and random effects models. RESULTS Initial search identified 4460 reference articles for 19 G and 22 G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G(n = 289) and 16 studies for 22G(n = 592) which met the inclusion criteria. EUS 19 G core biopsies had a pooled sensitivity of 91.6%(95%CI: 87.1-95.0) and pooled specificity of 95.9%(95%CI: 88.6-99.2), whereas EUS 22 G had a pooled sensitivity of 83.3%(95%CI: 79.7-86.6) and pooled specificity of 64.3%(95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19 G core biopsies was 9.08(95%CI: 1.12-73.66) and EUS 22 G core biopsies was 1.99(95%CI: 1.09-3.66).The negative likelihood ratio of EUS 19 G core biopsies was 0.12(95%CI: 0.07-0.24) and EUS 22 G core biopsies was 0.25(95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74(95%CI: 18.31-392.26) for 19 G core biopsies and 10.55(95% CI: 3.29-33.87) for 22 G needles. CONCLUSION EUS 19 G core biopsies have an excellent diagnostic value and seem to be better than EUS 22 G biopsies in detecting the correct etiology for a solid mass.
AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovid journals. Pooling was conducted by both fixed and random effects models. RESULTS Initial search identified 4460 reference articles for 19 G and 22 G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G(n = 289) and 16 studies for 22G(n = 592) which met the inclusion criteria. EUS 19 G core biopsies had a pooled sensitivity of 91.6%(95%CI: 87.1-95.0) and pooled specificity of 95.9%(95%CI: 88.6-99.2), whereas EUS 22 G had a pooled sensitivity of 83.3%(95%CI: 79.7-86.6) and pooled specificity of 64.3%(95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19 G core biopsies was 9.08(95%CI: 1.12-73.66) and EUS 22 G core biopsies was 1.99(95%CI: 1.09-3.66).The negative likelihood ratio of EUS 19 G core biopsies was 0.12(95%CI: 0.07-0.24) and EUS 22 G core biopsies was 0.25(95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74(95%CI: 18.31-392.26) for 19 G core biopsies and 10.55(95% CI: 3.29-33.87) for 22 G needles. CONCLUSION EUS 19 G core biopsies have an excellent diagnostic value and seem to be better than EUS 22 G biopsies in detecting the correct etiology for a solid mass.
AIM To compare the accuracy of endoscopic ultra-sonography(EUS) 19 G core biopsies and 22 G core biopsies in diagnosing the correct etiology for a solid mass.METHODS Articles were searched in Medline, Pub Med, and Ovid journals. Pooling was conducted by both fixed and random effects models. RESULTS Initial search identified 4460 reference articles for 19 G and 22 G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G(n = 289) and 16 studies for 22G(n = 592) which met the inclusion criteria. EUS 19 G core biopsies had a pooled sensitivity of 91.6%(95%CI: 87.1-95.0) and pooled specificity of 95.9%(95%CI: 88.6-99.2), whereas EUS 22 G had a pooled sensitivity of 83.3%(95%CI: 79.7-86.6) and pooled specificity of 64.3%(95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19 G core biopsies was 9.08(95%CI: 1.12-73.66) and EUS 22 G core biopsies was 1.99(95%CI: 1.09-3.66).The negative likelihood ratio of EUS 19 G core biopsies was 0.12(95%CI: 0.07-0.24) and EUS 22 G core biopsies was 0.25(95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74(95%CI: 18.31-392.26) for 19 G core biopsies and 10.55(95% CI: 3.29-33.87) for 22 G needles. CONCLUSION EUS 19 G core biopsies have an excellent diagnostic value and seem to be better than EUS 22 G biopsies in detecting the correct etiology for a solid mass.
引文
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23 Cox DR.The analysis of binary data.London:Methuen;1970
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2 Chang KJ.Endoscopic ultrasound(EUS)-guided fine needle aspiration(FNA)in the USA.Endoscopy 1998;30 Suppl 1:A159-A160[PMID:9765114 DOI:10.1055/s-2007-1001505]
3 Mortensen MB,Pless T,Durup J,Ainsworth AP,Plagborg GJ,Hovendal C.Clinical impact of endoscopic ultrasound-guided fine needle aspiration biopsy in patients with upper gastrointestinal tract malignancies.A prospective study.Endoscopy 2001;33:478-483[PMID:11437039 DOI:10.1055/s-2001-14966]
4 Shah JN,Ahmad NA,Beilstein MC,Ginsberg GG,Kochman ML.Clinical impact of endoscopic ultrasonography on the management of malignancies.Clin Gastroenterol Hepatol 2004;2:1069-1073[PMID:15625651 DOI:10.1016/S1542-3565(04)00444-6]
5 Itoi T,Sofuni A,Itokawa F,Irisawa A,Khor CJ,Rerknimitr R.Current status of diagnostic endoscopic ultrasonography in the evaluation of pancreatic mass lesions.Dig Endosc 2011;23 Suppl 1:17-21[PMID:21535194 DOI:10.1111/j.1443-1661.2011.01132.x]
6 Yoshinaga S,Suzuki H,Oda I,Saito Y.Role of endoscopic ultra-sound-guided fine needle aspiration(EUS-FNA)for diagnosis of solid pancreatic masses.Dig Endosc 2011;23 Suppl 1:29-33[PMID:21535197 DOI:10.1111/j.1443-1661.2011.01112.x]
7 Eloubeidi MA,Chen VK,Eltoum IA,Jhala D,Chhieng DC,Jhala N,Vickers SM,Wilcox CM.Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer:diagnostic accuracy and acute and 30-day complications.Am J Gastroenterol 2003;98:2663-2668[PMID:14687813]
8 Levy MJ,Wiersema MJ.EUS-guided Trucut biopsy.Gastrointest Endosc 2005;62:417-426[PMID:16111962 DOI:10.1016/j.gie.2005.04.044]
9 Wiersema MJ,Vilmann P,Giovannini M,Chang KJ,Wiersema LM.Endosonography-guided fine-needle aspiration biopsy:diagnostic accuracy and complication assessment.Gastroenterology1997;112:1087-1095[PMID:9097990 DOI:10.1016/S0016-5085(97)70164-1]
10 Mesa H,Stelow EB,Stanley MW,Mallery S,Lai R,Bardales RH.Diagnosis of nonprimary pancreatic neoplasms by endoscopic ultrasound-guided fine-needle aspiration.Diagn Cytopathol 2004;31:313-318[PMID:15468134 DOI:10.1002/dc.20142]
11 Bentz JS,Kochman ML,Faigel DO,Ginsberg GG,Smith DB,Gupta PK.Endoscopic ultrasound-guided real-time fine-needle aspiration:clinicopathologic features of 60 patients.Diagn Cytopathol1998;18:98-109[PMID:9484637 DOI:10.1002/(SICI)1097-0339(199802)18:2<98::AID-DC4>3.0.CO;2-P]
12 Fritscher-Ravens A,Topalidis T,Bobrowski C,Krause C,Thonke E,J?ckle S,Soehendra N.Endoscopic ultrasound-guided fine-needle aspiration in focal pancreatic lesions:a prospective intraindividual comparison of two needle assemblies.Endoscopy2001;33:484-490[PMID:11437040 DOI:10.1055/s-2001-14970]
13 Savides TJ.Tricks for improving EUS-FNA accuracy and maxi-mizing cellular yield.Gastrointest Endosc 2009;69:S130-S133[PMID:19179138 DOI:10.1016/j.gie.2008.12.018]
14 Mertz H,Gautam S.The learning curve for EUS-guided FNA of pancreatic cancer.Gastrointest Endosc 2004;59:33-37[PMID:14722544 DOI:10.1016/S0016-5107(03)02028-5]
15 Levy MJ.Endoscopic ultrasound-guided trucut biopsy of the pancreas:prospects and problems.Pancreatology 2007;7:163-166[PMID:17592229 DOI:10.1159/000104240]
16 Iglesias-Garcia J,Poley JW,Larghi A,Giovannini M,Petrone MC,Abdulkader I,Monges G,Costamagna G,Arcidiacono P,Biermann K,Rindi G,Bories E,Dogloni C,Bruno M,Dominguez-Mu?oz JE.Feasibility and yield of a new EUS histology needle:results from a multicenter,pooled,cohort study.Gastrointest Endosc 2011;73:1189-1196[PMID:21420083 DOI:10.1016/j.gie.2011.01.053]
17 Alatawi A,Beuvon F,Grabar S,Leblanc S,Chaussade S,Terris B,Barret M,Prat F.Comparison of 22G reverse-beveled versus standard needle for endoscopic ultrasound-guided sampling of solid pancreatic lesions.United European Gastroenterol J 2015;3:343-352[PMID:26279842 DOI:10.1177/2050640615577533]
18 Alatawi A,Beuvon F,Grabar S,Leblanc S,Chaussade S,Terris B,Prat F.Comparison of Fenestrated versus Standard Needles for Endoscopic Ultrasound-Guided Biopsy of Solid Pancreatic lesions.Gastrointest Endosc 2014;79:AB428-AB429[DOI:10.1016/j.gie.2014.02.593]
19 Ganc R,Colaiacovo R,Carbonari A,Altenfelder R,Pacheco AJ,Rocha H,Rossini L,Giovannini M.Endoscopic ultrasonography-fine-needle aspiration of solid pancreatic lesions:A prospective,randomized,single-blinded,comparative study using the 22 Gauge Echo Tip?Pro Core TM HD(A)and the 22 Gauge Echo Tip?Ultra HD(B)endoscopic ultrasound needles.Endosc Ultrasound 2014;3:S11[PMID:26425507 DOI:10.1016/j.gie.2014.02.591]
20 Jadad AR,Moore RA,Carroll D,Jenkinson C,Reynolds DJ,Gavaghan DJ,Mc Quay HJ.Assessing the quality of reports of randomized clinical trials:is blinding necessary?Control Clin Trials1996;17:1-12[PMID:8721797 DOI:10.1016/0197-2456(95)00134-4]
21 Stroup DF,Berlin JA,Morton SC,Olkin I,Williamson GD,Rennie D,Moher D,Becker BJ,Sipe TA,Thacker SB.Meta-analysis of observational studies in epidemiology:a proposal for reporting.Meta-analysis Of Observational Studies in Epidemiology(MOOSE)group.JAMA 2000;283:2008-2012[PMID:10789670DOI:10.1001/jama.283.15.2008]
22 Leemis LM,Trivedi KS.A Comparison of Approximate Interval Estimators for the Bernoulli Parameter.Am Stat 1996;50:63-68
23 Cox DR.The analysis of binary data.London:Methuen;1970
24 Agresti A.Analysis of ordinal categorical data.New York:John Wileys&Sons;1984
25 Deeks JJ.Systematic reviews of evaluations of diagnostic and screening tests.In Egger M,Smith GD,Altman DG(eds).Systematic Reviews in Health Care.Meta-analysis in context.London:BMJ Books;2001[DOI:10.1002/9780470693926.ch14]
26 Harbord RM,Egger M,Sterne JA.A modified test for small-study effects in meta-analyses of controlled trials with binary endpoints.Stat Med 2006;25:3443-3457[PMID:16345038 DOI:10.1002/sim.2380]
27 Begg CB,Mazumdar M.Operating characteristics of a rank corre-lation test for publication bias.Biometrics 1994;50:1088-1101[PMID:7786990 DOI:10.2307/2533446]
28 Sterne JA,Egger M,Smith GD.Systematic reviews in health care:Investigating and dealing with publication and other biases in meta-analysis.BMJ 2001;323:101-105[PMID:11451790 DOI:10.1136/bmj.323.7304.101]
29 Sterne JA,Egger M.Funnel plots for detecting bias in meta-analysis:guidelines on choice of axis.J Clin Epidemiol 2001;54:1046-1055[PMID:11576817 DOI:10.1016/S0895-4356(01)00377-8]
30 Karadsheh Z,Al-Haddad M.Endoscopic ultrasound guided fine needle tissue acquisition:where we stand in 2013?World J Gastroenterol 2014;20:2176-2185[PMID:24605016 DOI:10.3748/wjg.v20.i9.2176]
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