Abstract:
BACKGROUND:Preoperative diagnosis of solid pancreatic lesions remains challenging despite advancement in imaging technologies. EUS has the benefit of being a minimally invasive, well-tolerated procedure, although results are operator-dependent. The addition of FNA (EUS-guided FNA) provides samples for cytopathologic analysis, a major advantage over other imaging techniques. OBJECTIVE:To determine the diagnostic accuracy of EUS-FNA for pancreatic cancer. DESIGN:This is a meta-analysis of published studies assessing the diagnostic capability of EUS-FNA. Relevant studies were identified via MEDLINE and were included if they used a reference standard of definitive surgical histology or clinical follow-up of at least 6 months. MAIN OUTCOME MEASUREMENTS:Data from selected studies were analyzed by using test accuracy meta-analysis software, providing a pooled value for sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve. Cytology results were classified as inadequate, benign, atypical, suspicious, or malignant. Predefined subgroup analysis was performed. RESULTS:Thirty-three studies published between 1997 and 2009 were included, with a total number of 4984 patients. The pooled sensitivity for malignant cytology was 85% (95% confidence interval [CI], 84-86), and pooled specificity was 98% (95% CI, 0.97-0.99). If atypical and suspicious cytology results were included to determine true neoplasms, the sensitivity increased to 91% (95% CI, 90-92); however, the specificity was reduced to 94% (95% CI, 93-96). The diagnostic accuracy of EUS-FNA was enhanced in prospective, multicenter studies. LIMITATION:Publication bias was not a significant determinant of pooled accuracy. CONCLUSION:This meta-analysis demonstrates that EUS-FNA is a highly accurate diagnostic test for solid neoplasms of the pancreas and should be considered when algorithms for investigating solid pancreatic lesions are being planned.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Hewitt MJ,McPhail MJ,Possamai L,Dhar A,Vlavianos P,Monahan KJdoi
10.1016/j.gie.2011.08.049subject
Has Abstractpub_date
2012-02-01 00:00:00pages
319-31issue
2eissn
0016-5107issn
1097-6779pii
S0016-5107(11)02166-3journal_volume
75pub_type
杂志文章,meta分析abstract:BACKGROUND:The treatment of patients with bile duct stones and acute suppurative cholangitis is emergent biliary decompression either by endoscopic sphincterotomy, nasobiliary drainage, or stent insertion. The aim of this retrospective study was to determine whether endoscopic sphincterotomy, in addition to an internal...
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:Gastrointestinal endoscopy
pub_type: 临床试验,杂志文章
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更新日期:1997-02-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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