Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
Eur Radiol. 2022 Mar;32(3):1747-1756. doi: 10.1007/s00330-021-08301-1. Epub 2021 Sep 18.
To perform a systematic review and meta-analysis to determine the diagnostic performance of percutaneous transluminal forceps biopsy (PTFB) for differentiating malignant from benign biliary stricture.
A comprehensive literature search of the PubMed, EMBASE, and Ovid MEDLINE databases was conducted to identify original articles published between January 2001 and January 2021 reporting the diagnostic accuracy of PTFB. A random-effects model was used to summarize the diagnostic odds ratio and other measures of accuracy.
Fourteen studies involving 1762 patients met the inclusion criteria and were included in the meta-analysis. The meta-analysis summary estimates of PTFB for diagnosis of malignant biliary strictures were as follows: sensitivity 81% (95% confidence interval [CI], 78-81%); specificity 100% (95% CI, 98-100%); diagnostic odds ratio 85.34 (95% CI, 38.37-189.81). The area under the curve of PTFB was 0.948 in the diagnosis of malignant biliary strictures. The diagnostic sensitivity was higher in intrinsic (85%) than in extrinsic (73%) biliary strictures. The pooled rate of all complications was 10.3% (95% CI, 7.0-14.2%), including a major complication rate of 3.1%.
These data demonstrate that PTFB is sensitive and highly specific for diagnosing malignancy in biliary strictures. PTFB should be incorporated into future guidelines for tissue sampling in biliary cancer, especially in cases with failed endoscopic management.
• PTFB had a good overall diagnostic performance for differentiating malignant from benign biliary strictures, with a meta-analysis summary estimate of 81% for sensitivity and 100% for specificity. • PTFB had higher sensitivity for cholangiocarcinoma (85%) than for other cancers (73%). • PTFB had a 100% technical success rate and a 10.3% rate for complications, including a 3.1% rate for major complications.
进行系统评价和荟萃分析，以确定经皮经腔活检钳（PTFB）在鉴别良恶性胆道狭窄方面的诊断性能。
对 PubMed、EMBASE 和 Ovid MEDLINE 数据库进行全面文献检索，以确定 2001 年 1 月至 2021 年 1 月期间报告 PTFB 诊断准确性的原始文章。使用随机效应模型总结诊断优势比和其他准确性测量值。
有 14 项研究纳入了 1762 名患者，符合荟萃分析的纳入标准。PTFB 诊断恶性胆道狭窄的汇总估计值如下：敏感性为 81%（95%置信区间 [CI]，78-81%）；特异性为 100%（95% CI，98-100%）；诊断优势比为 85.34（95% CI，38.37-189.81）。PTFB 对恶性胆道狭窄的诊断曲线下面积为 0.948。内在（85%）胆道狭窄的诊断敏感性高于外在（73%）胆道狭窄。所有并发症的汇总发生率为 10.3%（95% CI，7.0-14.2%），其中主要并发症发生率为 3.1%。
这些数据表明，PTFB 对胆道狭窄的良恶性诊断具有较高的敏感性和特异性。PTFB 应纳入未来胆道癌的组织取样指南，特别是在内镜治疗失败的情况下。
PTFB 对鉴别良恶性胆道狭窄具有良好的整体诊断性能，其敏感性汇总估计值为 81%，特异性为 100%。
PTFB 对胆管癌（85%）的敏感性高于其他癌症（73%）。
PTFB 具有 100%的技术成功率和 10.3%的并发症发生率，其中主要并发症发生率为 3.1%。
