Facciorusso Antonio, Stasi Elisa, Di Maso Marianna, Serviddio Gaetano, Ali Hussein Mohammed Salah, Muscatiello Nicola
Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy.
Gastroenterology Unit, IRCCS Saverio De Bellis, Castellana Grotte (Ba), Italy.
United European Gastroenterol J. 2017 Oct;5(6):846-853. doi: 10.1177/2050640616680972. Epub 2016 Nov 17.
Robust data in favour of a clear superiority of 22 versus 25 Gauge needles for endoscopic ultrasound-guided fine needle aspiration are still lacking.
We aimed to compare the diagnostic sensitivity, specificity and safety of these two needles for endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions.
A computerized bibliographic search was restricted to randomized controlled trials only. Pooled effects were calculated using a random-effects model and expressed in terms of risk ratio and 95% confidence interval.
We analysed seven trials with 689 patients and 732 lesions (295 sampled with 22 Gauge needle, 309 with 25 Gauge needle, and 128 with both needles). A non-significant superiority of 25 Gauge in terms of pooled sensitivity (risk ratio: 0.93, 0.91-0.95 versus 0.89, 0.85-0.94 of 22 Gauge needle; = 0.13) and no difference in terms of specificity (1.00, 0.98-1.00 in both groups; = 0.85) were observed. Sample adequacy was similar between the two devices (risk ratio: 1.03, 0.99-1.06; = 0.15). Very few adverse events were observed and did not impact on patient outcomes.
Our meta-analysis reveals non-superiority of 25 Gauge over 22 Gauge; hence no definitive recommendations over the use of one particular device can be made.
目前仍缺乏有力数据支持22号针在内镜超声引导下细针穿刺方面明显优于25号针。
我们旨在比较这两种针在内镜超声引导下对实性胰腺病变进行细针穿刺时的诊断敏感性、特异性和安全性。
计算机化文献检索仅限于随机对照试验。采用随机效应模型计算合并效应，并以风险比和95%置信区间表示。
我们分析了7项试验，涉及689例患者和732个病变（295个用22号针采样，309个用25号针采样，128个用两种针采样）。在合并敏感性方面，25号针无显著优势（风险比：0.93，95%置信区间0.91 - 0.95，而22号针为0.89，95%置信区间0.85 - 0.94；P = 0.13），在特异性方面两组无差异（两组均为1.00，95%置信区间0.98 - 1.00；P = 0.85）。两种器械的样本充足率相似（风险比：1.03，95%置信区间0.99 - 1.06；P = 0.15）。观察到的不良事件极少，且未影响患者预后。
我们的荟萃分析显示25号针并不优于22号针；因此，无法就使用某一种特定器械给出明确建议。
