Department of Gastroenterology, the 2nd Clinical Medicine College (Shenzhen People's Hospital) of Jinan University, Shenzhen, 518020, China.
Department of General Surgery, Shenzhen Children's Hospital, Shenzhen 518026, China.
J Gastroenterol Hepatol. 2020 Aug;35(8):1264-1276. doi: 10.1111/jgh.14999. Epub 2020 Feb 23.
Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is used to diagnose lesions within or adjacent to the digestive tract. However, there is no report on the overall diagnostic accuracy, technical success, and adverse events of FNB. The aims of this study were to conduct a systematic review and meta-analysis to comprehensively assess the diagnostic accuracy, technical success, and adverse events of FNB.
Pubmed, Embase, and Cochrane Library databases were searched for relevant articles published in English from January 1998 to May 2019 (No. CRD42019141647). Primary outcomes were EUS-FNB related diagnostic accuracy rate, technical success rate, and adverse event rate.
A total of 51 articles including 5330 patients met our criteria. The overall EUS-FNB related diagnostic accuracy rate, technical success rate, and adverse event rate was 90.82% [95% confidence interval (CI) 88.69-92.76%], 99.71% [95% CI 99.35-99.93%], and 0.59% [95% CI 0.29-1.0%], respectively. Biopsy with 22G needle could increase the diagnostic accuracy rate and technical success rate to 92.17% [95% CI 89.32-94.61%] and 99.88% [95% CI 99.64-99.99%], respectively, and decrease the adverse event to 0.37% [95% CI 0.08-0.87%]. Moreover, it showed that 22G needle was an independent factor associated with a higher diagnostic accuracy rate and technical success rate and a lower adverse event rate (P = 0.04, P < 0.001, and P = 0.04, respectively) by univariate and multivariate meta-regression analyses.
Endoscopic ultrasound-guided fine-needle biopsy is a feasible and safe procedure for lesions within or adjacent to the digestive tract. Biopsy using 22G needle could increase the diagnostic accuracy rate and technical success rate and decrease adverse event rate during the FNB procedure.
内镜超声引导下细针穿刺活检（EUS-FNB）用于诊断消化道内或邻近的病变。然而，目前尚无关于 FNB 的总体诊断准确性、技术成功率和不良事件的报道。本研究旨在进行系统评价和荟萃分析，以全面评估 FNB 的诊断准确性、技术成功率和不良事件。
检索 1998 年 1 月至 2019 年 5 月以英文发表的相关文献，数据库包括 Pubmed、Embase 和 Cochrane Library。主要结局指标为 EUS-FNB 相关的诊断准确性、技术成功率和不良事件发生率。
共纳入 51 篇文章，共 5330 例患者，符合标准。EUS-FNB 相关的总体诊断准确性、技术成功率和不良事件发生率分别为 90.82%[95%置信区间（CI）88.69%-92.76%]、99.71%[95% CI 99.35%-99.93%]和 0.59%[95% CI 0.29%-1.0%]。使用 22G 针进行活检可使诊断准确性和技术成功率分别提高至 92.17%[95% CI 89.32%-94.61%]和 99.88%[95% CI 99.64%-99.99%]，同时降低不良事件发生率至 0.37%[95% CI 0.08%-0.87%]。此外，单因素和多因素荟萃回归分析表明，22G 针是与更高的诊断准确性和技术成功率以及更低的不良事件发生率相关的独立因素（P=0.04、P<0.001 和 P=0.04）。
内镜超声引导下细针穿刺活检是一种可行且安全的消化道内或邻近病变的诊断方法。使用 22G 针进行活检可提高诊断准确性和技术成功率，降低不良事件发生率。
