Bhandari Megha, Samanta Jayanta, Spadaccini Marco, Fugazza Alessandro, Crinò Stefano Francesco, Gkolfakis Paraskevas, Triantafyllou Konstantinos, Dhar Jahnvi, Maida Marcello, Pugliese Nicola, Hassan Cesare, Repici Alessandro, Aghemo Alessio, Serviddio Gaetano, Facciorusso Antonio
Hepatology Department, Cambridge University Hospital, Cambridge CB4 1GN, UK.
Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Diagnostics (Basel). 2024 Jun 12;14(12):1238. doi: 10.3390/diagnostics14121238.
The efficacy of endoscopic ultrasound-guided liver biopsy (EUS-LB) compared to percutaneous liver biopsy (PC-LB) remains uncertain.
Our data consist of randomized controlled trials (RCTs) comparing EUS-LB to PC-LB, found through a literature search via PubMed/Medline and Embase. The primary outcome was sample adequacy, whereas secondary outcomes were longest and total lengths of tissue specimens, diagnostic accuracy, and number of complete portal tracts (CPTs).
Sample adequacy did not significantly differ between EUS-LB and PC-LB (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.58-2.38; = 0.65), with very low evidence quality and inadequate sample size as per trial sequential analysis (TSA). The two techniques were equivalent with respect to diagnostic accuracy (RR: 1; CI: 0.95-1.05; = 0.88), mean number of complete portal tracts (mean difference: 2.29, -4.08 to 8.66; = 0.48), and total specimen length (mean difference: -0.51, -20.92 to 19.9; = 0.96). The mean maximum specimen length was significantly longer in the PC-LB group (mean difference: -3.11, -5.51 to -0.71; = 0.01), and TSA showed that the required information size was reached.
EUS-LB and PC-LB are comparable in terms of diagnostic performance although PC-LB provides longer non-fragmented specimens.
与经皮肝活检（PC-LB）相比，内镜超声引导下肝活检（EUS-LB）的疗效仍不确定。
我们的数据包括通过PubMed/Medline和Embase进行文献检索找到的比较EUS-LB和PC-LB的随机对照试验（RCT）。主要结局是样本充足性，而次要结局是组织标本的最长和总长度、诊断准确性以及完整门静脉分支（CPT）的数量。
EUS-LB和PC-LB在样本充足性方面无显著差异（风险比[RR]1.18；95%置信区间[CI]0.58-2.38；P = 0.65），根据序贯试验分析（TSA），证据质量极低且样本量不足。在诊断准确性（RR：1；CI：0.95-1.05；P = 0.88）、完整门静脉分支的平均数量（平均差异：2.29，-4.08至8.66；P = 0.48）和标本总长度（平均差异：-0.51，-20.92至19.9；P = 0.96）方面，两种技术相当。PC-LB组的平均最大标本长度显著更长（平均差异：-3.11，-5.51至-0.71；P = 0.01），TSA显示已达到所需的信息量。
EUS-LB和PC-LB在诊断性能方面具有可比性，尽管PC-LB提供的非碎片化标本更长。
