Department of Ultrasound Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).
Key Laboratory of Precision Diagnosis and Treatment for Hepatobiliary and Pancreatic Tumor of Zhejiang Province, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2018 Nov 19;24:8333-8341. doi: 10.12659/MSM.911405.
BACKGROUND Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has been used for detecting pancreatic cancer. We aimed to compare the diagnostic yield of both 22-gauge and 25-gauge EUS-FNA for the detection of pancreatic cancer. MATERIAL AND METHODS We searched the electronic databases including PubMed, EMBASE, Web of Science, Scopus, and Cochrane Library up to June 13, 2017. Two reviewers independently screened studies and extracted data. RESULTS We analyzed data from 1824 patients from 16 included studies. The estimated pooled data for the 22-gauge needles reported sensitivity was 0.89 (0.83-0.93), specificity was 1.00 (0.74-1.00), positive LR was 485.28 (2.55-92 000) and negative LR was 0.11 (0.07-0.17). Results for the 25-gauge needles showed the pooled sensitivity, specificity, positive and negative LR was 0.90 (0.86-0.93), 0.99 (0.89-1.00), 59.53 (7.99-443.66), and 0.10 (0.07-0.14), respectively. The 25-gauge needle had significantly higher pooled sensitivity than the 22-gauge needle (0.90 vs. 0.87, χ²=5.26, P=0.02) while there was no difference in the pooled specificity (0.96 vs. 0.98, χ²=2.12, P=0.15). The quality of most studies was assessed favorable using QUADAS-2 (quality assessment of diagnostic accuracy studies-2). CONCLUSIONS Our findings revealed that the 25-gauge EUS-FNA used for pancreatic lesions could have a higher diagnostic yield than using 22-gauge EUS-FNA. Nevertheless, well-designed prospective studies recruiting more patients are needed.
内镜超声引导下细针抽吸（EUS-FNA）已用于诊断胰腺癌。本研究旨在比较 22 号和 25 号 EUS-FNA 检测胰腺癌的诊断效能。
我们检索了PubMed、EMBASE、Web of Science、Scopus 和 Cochrane Library 等电子数据库，检索时间截至 2017 年 6 月 13 日。两位评价者独立筛选研究并提取数据。
我们对纳入的 16 项研究中的 1824 例患者的数据进行了分析。22 号针的汇总数据估计敏感性为 0.89（0.83-0.93），特异性为 1.00（0.74-1.00），阳性似然比为 485.28（2.55-92000），阴性似然比为 0.11（0.07-0.17）。25 号针的汇总结果显示，敏感性、特异性、阳性似然比和阴性似然比分别为 0.90（0.86-0.93）、0.99（0.89-1.00）、59.53（7.99-443.66）和 0.10（0.07-0.14）。25 号针的汇总敏感性明显高于 22 号针（0.90 与 0.87， χ²=5.26，P=0.02），而特异性无差异（0.96 与 0.98， χ²=2.12，P=0.15）。使用 QUADAS-2（诊断准确性研究的质量评估-2）评估大多数研究的质量良好。
我们的研究结果表明，与使用 22 号针相比，EUS-FNA 用于胰腺病变时可能具有更高的诊断效能。然而，需要设计更好的前瞻性研究，纳入更多的患者。
