Facciorusso Antonio, Bajwa Harshvardhan Singh, Menon Kavitha, Buccino Vincenzo Rosario, Muscatiello Nicola
Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy.
Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
Endosc Ultrasound. 2020 May-Jun;9(3):167-174. doi: 10.4103/eus.eus_4_19.
Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles.
Computerized bibliographic search on the main databases was performed and restricted to only randomized controlled trials. Summary estimates were expressed regarding risk ratio (RR) and 95% confidence interval.
A total of 11 trials with 833 patients were analyzed. The two needles resulted comparable in terms of diagnostic accuracy (RR 1.02, 0.97-1.08; P = 0.46), sample adequacy (RR 1.01, 0.96-1.06; P = 0.61), and histological core procurement (RR 1.01, 0.89-1.15; P = 0.86). Pooled sensitivity in the diagnosis of pancreatic cancer was 93.1% (87.9%-98.4%) and 90.4% (86.3%-94.5%) with biopsy and aspirate, respectively, whereas specificity for detecting pancreatic cancer was 100% with both needles. Analysis of the number of needle passes showed a nonsignificantly positive trend in favor of FNB (mean difference: -0.32, -0.66-0.02; P = 0.07).
Our meta-analysis stands for a nonsuperiority of 22G FNB over 22G FNA; hence, no definitive recommendations on the use of a particular device can be made.
缺乏有力数据表明在超声内镜引导下对胰腺肿块进行采样时，22G细针活检（FNB）比22G细针穿刺抽吸活检（FNA）具有明显优势。本研究的目的是比较这两种针的诊断结果和样本充足率。
在主要数据库上进行计算机化文献检索，仅限于随机对照试验。以风险比（RR）和95%置信区间表示汇总估计值。
共分析了11项试验中的833例患者。两种针在诊断准确性（RR 1.02，0.97 - 1.08；P = 0.46）、样本充足率（RR 1.01，0.96 - 1.06；P = 0.61）和组织学核心获取（RR 1.01，0.89 - 1.15；P = 0.86）方面相当。活检和抽吸诊断胰腺癌的合并敏感性分别为93.1%（87.9% - 98.4%）和90.4%（86.3% - 94.5%），而两种针检测胰腺癌的特异性均为100%。针穿刺次数分析显示，有利于FNB的趋势无显著统计学意义（平均差异：-0.32，-0.66 - 0.02；P = 0.07）。
我们的荟萃分析表明22G FNB并不优于22G FNA；因此，无法就使用特定设备给出明确建议。
