Department of General Surgery, Affiliated Provincial Hospital of Anhui Medical University, Hefei, China.
J Cancer Res Clin Oncol. 2012 Sep;138(9):1433-41. doi: 10.1007/s00432-012-1268-1. Epub 2012 Jun 30.
To summarize EUS-FNA test performance in suspected pancreatic malignancy with meta-analysis.
Two reviewers searched MEDLINE (PubMed and Ovid from January 2002 to January 2012) database to identify relevant studies. The reference lists of the trials were manually searched. Included studies used histopathology or clinical and morphological (CT and MRI and US) follow-up as the "gold standard" and provided sufficient data to construct a diagnostic 2 × 2 table. A statistical program of Meta-Disc was used to calculate the pooled sensitivity, specificity, positive LR, negative LR, DOR, and the SROC curve. Subgroup analysis and meta-regression were calculated to evaluate potential sources of heterogeneity.
A total of 15 studies with 1860 patients were included for the analysis. The pooled sensitivity and specificity of EUS-FNA were 92 % (95 % CI = 91-93 %, p < 0.001, I (2) = 69.6 %) and 96 % (95 % CI = 93-98 %, p = 0.006, I (2) = 54.9 %), respectively. The positive LR and negative LR were 14.24 (95 % CI = 7.78-26.07) and 0.09 (95 % CI = 0.07-0.13), respectively. The area under the curve was 0.974. The subgroup analysis of six studies with rapid on-site evaluation (ROSE) showed a pooled sensitivity of 95 % (95 % CI = 93-96 %), with p value equal 0.622 and I (2) = 0. The sensitivity analysis of ten high-quality studies (a score of ≥4) showed a pooled sensitivity of 94 % (95 % CI = 93-96 %, p = 0.144, I (2) = 33.1 %), and the pooled specificity was 0.95 (95 % CI, 0.91-0.97).
EUS-FNA had overall excellent specificity and sensitivity in accurately diagnosing solid pancreatic masses. ROSE could help to improve the accuracy of diagnostic test.
采用荟萃分析总结超声内镜引导下细针抽吸（EUS-FNA）检查在疑似胰腺恶性肿瘤中的应用价值。
两位评审员检索了 MEDLINE（PubMed 和 Ovid 自 2002 年 1 月至 2012 年 1 月）数据库以确定相关研究。通过手工检索这些试验的参考文献列表来进一步搜索。纳入的研究采用组织病理学或临床和形态学（CT、MRI 和 US）随访作为“金标准”，并提供了足够的数据来构建诊断 2×2 表。采用 Meta-Disc 统计程序计算汇总敏感性、特异性、阳性似然比、阴性似然比、优势比和 SROC 曲线。进行亚组分析和 meta 回归来评估潜在的异质性来源。
共有 15 项研究，包含 1860 例患者，被纳入分析。EUS-FNA 的汇总敏感性和特异性分别为 92%（95%CI=91-93%，p<0.001，I2=69.6%）和 96%（95%CI=93-98%，p=0.006，I2=54.9%）。阳性似然比和阴性似然比分别为 14.24（95%CI=7.78-26.07）和 0.09（95%CI=0.07-0.13）。曲线下面积为 0.974。对 6 项具有快速现场评估（ROSE）的研究进行亚组分析，结果显示汇总敏感性为 95%（95%CI=93-96%），p 值为 0.622，I2=0。对 10 项高质量研究（评分≥4）的敏感性分析显示，汇总敏感性为 94%（95%CI=93-96%，p=0.144，I2=33.1%），汇总特异性为 0.95（95%CI，0.91-0.97）。
EUS-FNA 对准确诊断实性胰腺肿块具有良好的总体特异性和敏感性。ROSE 有助于提高诊断试验的准确性。
