Facciorusso Antonio, Mohan Babu P, Crinò Stefano Francesco, Ofosu Andrew, Ramai Daryl, Lisotti Andrea, Chandan Saurabh, Fusaroli Pietro
Department of Medical and Surgical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy.
Gastroenterology and Hepatology, University of Utah Health, Salt Lake City, UT, USA.
Expert Rev Gastroenterol Hepatol. 2021 Jul;15(7):821-828. doi: 10.1080/17474124.2021.1880893. Epub 2021 Jan 26.
It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. Aim of this meta-analysis was to compare the diagnostic outcomes of these two techniques.
We searched the PubMed/Medline and Embase database through October 2020 and identified 6 studies, of which 2 randomized controlled trials (recruiting 701 patients). We performed pairwise meta-analysis through a random effects model and expressed data as odds ratio (OR) and 95% confidence interval (CI).
Pooled diagnostic sensitivity was 84.6% (95% CI 80.7%-88.6%) with CH-EUS-FNA and 75.3% (67%-83.5%) with EUS-FNA, with evidence of a significant superiority of the former (OR 1.74, 95% CI 1.26-2.40; p < 0.001). Subgroup analysis confirmed the superiority of CH-EUS-FNA over EUS-FNA only in larger lesions. Pooled diagnostic accuracy was 88.8% (85.6%-91.9%) in CH-EUS-FNA group and 83.6% (79.4%-87.8%) in EUS-FNA group (OR 1.52, 1.01-2.31; p = 0.05). Pooled sample adequacy was 95.1% (91.1%-99.1%) with CH-EUS-FNA and 89.4% (81%-97.8%) with EUS-FNA (OR 2.40, 1.38-4.17; p = 0.02).
CH-EUS-FNA seems to be superior to standard EUS-FNA in patients with pancreatic masses. Further trials are needed to confirm these results.
与标准超声内镜引导下细针穿刺活检（EUS-FNA）相比，超声内镜造影增强细针穿刺活检（CH-EUS-FNA）在获取胰腺肿块组织方面是否能取得更好的结果仍不明确。本荟萃分析的目的是比较这两种技术的诊断结果。
我们检索了截至2020年10月的PubMed/Medline和Embase数据库，共识别出6项研究，其中2项为随机对照试验（纳入701例患者）。我们通过随机效应模型进行成对荟萃分析，并将数据表示为比值比（OR）和95%置信区间（CI）。
CH-EUS-FNA的合并诊断敏感性为84.6%（95%CI 80.7%-88.6%），EUS-FNA为75.3%（67%-83.5%），有证据表明前者具有显著优势（OR 1.74，95%CI 1.26-2.40；p<0.001）。亚组分析证实，CH-EUS-FNA仅在较大病变中优于EUS-FNA。CH-EUS-FNA组的合并诊断准确性为88.8%（85.6%-91.9%），EUS-FNA组为83.6%（79.4%-87.8%）（OR 1.52，1.01-2.31；p = 0.05）。CH-EUS-FNA的合并样本充足率为95.1%（91.1%-99.1%），EUS-FNA为89.4%（81%-97.8%）（OR 2.40，1.38-4.17；p = 0.02）。
CH-EUS-FNA在胰腺肿块患者中似乎优于标准EUS-FNA。需要进一步试验来证实这些结果。
