Endoscopic Ultrasound-Guided Fine Needle Biopsy Needles Provide Higher Diagnostic Yield Compared to Endoscopic Ultrasound-Guided Fine Needle Aspiration Needles When Sampling Solid Pancreatic Lesions: A Meta-Analysis
2
조회
0
다운로드
4
인용
0
참고문헌
키워드
초록
Background/Aims: Studies comparing the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andendoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for solid pancreatic lesions have been inconclusive with no clearsuperiority. The aim of this meta-analysis was to compare the diagnostic accuracy and safety between the two sampling techniques. Methods: We performed a systematic search of randomized controlled trials published between 2012 and 2019. The primaryoutcome was overall diagnostic accuracy. Secondary outcomes included adverse event rates, cytopathologic and histopathologicaccuracy, and the mean number of passes required to obtain adequate tissue between FNA and FNB needles. Fixed and randomeffect models with pooled estimates of target outcomes were developed. Results: Eleven studies involving 1,365 participants were included for analysis. When compared to FNB, FNA had a significantreduction in diagnostic accuracy (81% and 87%, p=0.005). In addition, FNA provided reduced cytopathologic accuracy (82% and89%, p=0.04) and an increased number of mean passes required compared to FNB (2.3 and 1.6, respectively, p<0.0001). There wasno difference in adverse event rate between FNA and FNB needles (1.8% and 2.3% respectively, p=0.64). Conclusions: FNB provides superior diagnostic accuracy without compromising safety when compared to FNA. FNB should bereadily considered by endosonographers when evaluating solid pancreatic masses.
Abstract
Background/Aims: Studies comparing the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andendoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for solid pancreatic lesions have been inconclusive with no clearsuperiority. The aim of this meta-analysis was to compare the diagnostic accuracy and safety between the two sampling techniques. Methods: We performed a systematic search of randomized controlled trials published between 2012 and 2019. The primaryoutcome was overall diagnostic accuracy. Secondary outcomes included adverse event rates, cytopathologic and histopathologicaccuracy, and the mean number of passes required to obtain adequate tissue between FNA and FNB needles. Fixed and randomeffect models with pooled estimates of target outcomes were developed. Results: Eleven studies involving 1,365 participants were included for analysis. When compared to FNB, FNA had a significantreduction in diagnostic accuracy (81% and 87%, p=0.005). In addition, FNA provided reduced cytopathologic accuracy (82% and89%, p=0.04) and an increased number of mean passes required compared to FNB (2.3 and 1.6, respectively, p<0.0001). There wasno difference in adverse event rate between FNA and FNB needles (1.8% and 2.3% respectively, p=0.64). Conclusions: FNB provides superior diagnostic accuracy without compromising safety when compared to FNA. FNB should bereadily considered by endosonographers when evaluating solid pancreatic masses.
참고문헌 (32)
- Siegel RL, "Cancer statistics, 2018", CA Cancer J Clin, 68, pp.7~30 (2018)
- Siegel RL, "Cancer statistics, 2019", CA Cancer J Clin, 69, pp.7~34 (2019)
- Kleeff J, "Pancreatic cancer", Nat Rev Dis Primers, 2, pp.16022~ (2016)
- Nayar MK, "Comparison of the diagnostic performance of 2 core biopsy needles for EUS-guided tissue acquisition from solid pancreatic lesions", Gastrointest Endosc, 85, pp.1017~1024 (2017)
- Ishikawa T, "Diagnostic yield of small histological cores obtained with a new EUS-guided fine needle biopsy system", Surg Endosc, 31, pp.5143~5149 (2017)
- Hewitt MJ, "EUS-guided FNA for diagnosis of solid pancreatic neoplasms : a meta-analysis", Gastrointest Endosc, 75, pp.319~331 (2012)
- Noh DH, "Comparison of 22-gauge standard fine needle versus core biopsy needle for endoscopic ultrasound-guided sampling of suspected pancreatic cancer : a randomized crossover trial", Scand J Gastroenterol, 53, pp.94~99 (2018)
- Nagula S, "Comparison of endoscopic ultrasound-fine-needle aspiration and endoscopic ultrasound-fine-needle biopsy for solid lesions in a multicenter, randomized trial", Clin Gastroenterol Hepatol, 16, pp.1307~1313 (2018)
- Hedenström P, "EUS-guided reverse bevel fine-needle biopsy sampling and open tip fine-needle aspiration in solid pancreatic lesions-a prospective, comparative study", Scand J Gastroenterol, 53, pp.231~237 (2018)
- Cheng B, "Analysis of fine-needle biopsy vs fine-needle aspiration in diagnosis of pancreatic and abdominal masses : a prospective, multicenter, randomized controlled trial", Clin Gastroenterol Hepatol, 16, pp.1314~1321 (2018)
- Liberati A, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions : explanation and elaboration", Ann Intern Med, 151, pp.W65~W94 (2009)
- Higgins JP, "The Cochrane collaboration’s tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)
- Egger M, "Bias in meta-analysis detected by a simple, graphical test", BMJ, 315, pp.629~634 (1997)
- Higgins JP, "Quantifying heterogeneity in a meta-analysis", Stat Med, 21, pp.1539~1558 (2002)
- van Riet PA, "A multicenter randomized trial comparing a 25-gauge EUS fine-needle aspiration device with a 20-gauge EUS fine-needle biopsy device", Gastrointest Endosc, 89, pp.329~339 (2019)
- Tian L, "Evaluation of 22G fine-needle aspiration(FNA)versus fine-needle biopsy(FNB)for endoscopic ultrasound-guided sampling of pancreatic lesions : a prospective comparison study", Surg Endosc, 32, pp.3533~3539 (2018)
- Kamata K, "Histologic diagnosis of pancreatic masses using 25-gauge endoscopic ultrasound needles with and without a core trap : a multicenter randomized trial", Endoscopy, 48, pp.632~638 (2016)
- Aadam AA, "A randomized controlled cross-over trial and cost analysis comparing endoscopic ultrasound fine needle aspiration and fine needle biopsy", Endosc Int Open, 4, pp.E497~E505 (2016)
- Alatawi A, "Comparison of 22G reverse-beveled versus standard needle for endoscopic ultrasound-guided sampling of solid pancreatic lesions", United European Gastroenterol J, 3, pp.343~352 (2015)
- Vanbiervliet G, "Core needle versus standard needle for endoscopic ultrasound-guided biopsy of solid pancreatic masses : a randomized crossover study", Endoscopy, 46, pp.1063~1070 (2014)
- Lee YN, "Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses : a randomized parallel-group study", Endoscopy, 46, pp.1056~1062 (2014)
- Hucl T, "Feasibility and efficiency of a new 22G core needle : a prospective comparison study", Endoscopy, 45, pp.792~798 (2013)
- Bang JY, "Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions", Gastrointest Endosc, 76, pp.321~327 (2012)
- Li H, "Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: a meta-analysis of randomized controlled trials", Medicine (Baltimore), 97, pp.e0207~ (2018)
- Wang J, "Endoscopic ultrasound guided fine needle aspiration versus endoscopic ultrasound guided fine needle biopsy in sampling pancreatic masses: a meta-analysis", Medicine (Baltimore), 96, pp.e7452~ (2017)
- Conti CB, "Endoscopic ultrasound-guided sampling of solid pancreatic masses : the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?", World J Gastrointest Endosc, 11, pp.454~471 (2019)
- Mohan BP, "Efficacy and safety of EUS-guided liver biopsy : a systematic review and meta-analysis", Gastrointest Endosc, 89, pp.238~246 (2019)
- Okasha HH, "Endoscopic ultrasound-guided fine needle aspiration versus percutaneous ultrasound-guided fine needle aspiration in diagnosis of focal pancreatic masses", Endosc Ultrasound, 2, pp.190~193 (2013)
- Mohamadnejad M, "Increasing number of passes beyond 4 does not increase sensitivity of detection of pancreatic malignancy by endoscopic ultrasound-guided fine-needle aspiration", Clin Gastroenterol Hepatol, 15, pp.1071~1078 (2017)
- Erickson RA, "Factors predicting the number of EUS-guided fine-needle passes for diagnosis of pancreatic malignancies", Gastrointest Endosc, 51, pp.184~190 (2000)
- Abdelfatah MM, "Cohort study comparing the diagnostic yields of 2 different EUS fine-needle biopsy needles", Gastrointest Endosc, 87, pp.495~500 (2018)
- Facciorusso A, "Diagnostic yield of Franseen and fork-tip biopsy needles for endoscopic ultrasound-guided tissue acquisition : a meta-analysis", Endosc Int Open, 7, pp.E1221~E1230 (2019)