Zhu CL, Huang Q, Liu CH, Xie F, Yao Q. Diagnostic value of endoscopic ultrasound-guided fine-needle aspiration for solid pancreatic masses: A meta-analysis.
Shijie Huaren Xiaohua Zazhi 2012;
20:1667-1676. [DOI:
10.11569/wcjd.v20.i18.1667]
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Abstract
AIM: To establish the overall diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for solid pancreatic masses.
METHODS: We searched PubMed (1966/2011-10), Cochrane Library (from establishment to 2011-10), CNKI (1994/2011-10), CBM (1978/2011-10) and Wanfang (2000/2011-10) databases to find all diagnostic tests about EUS-FNA for solid pancreatic masses. After collecting studies according to inclusion criteria of diagnostic tests, data (study background, design information and diagnostic parameters) were extracted. QUADAS items were used to evaluate the qualities of the included studies. Meta-disc software was used to handle data of included studies and to examine heterogeneity. The effect-model was selected according to outcomes of heterogeneity. After all included studies were weighted and combined, sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and their 95%CI were calculated, and SROC curve was drawn.
RESULTS: A total of 280 potentially relevant studies were retrieved. According to eligibility criteria, 18 studies were included (all in English). The meta-analysis results are as follows: pooled sensitivity 0.90 (95%CI, 0.89-0.92), pooled specificity 0.95 (95%CI, 0.93-0.97), PLR 13.56 (95%CI, 8.31-22.15), NLR 0.12 (95%CI, 0.10-0.15), DOR 143.62 (95%CI, 93.98-219.46) and SROC AUC 0.9711 (Q* = 0.9215). Moreover, subgroup analysis was performed to identify the sources of heterogeneity according to the presence or absence of an on-site cytopathologist. The SROC AUC was 0.9757 (Q* = 0.9295) in the presence of an on-site cytopathologist. The DOR in the presence of an on-site cytopathologist was higher that in the absence of an on-site cytopathologist [173.37 (95%CI, 98.09-306.44) vs 113.64 (95%CI, 60.22-214.46)].
CONCLUSION: EUS-FNA has a high sensitivity and specificity in the diagnosis of solid pancreatic masses, especially in the presence of an on-site cytopathologist.
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