How Good Is Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Diagnosing the Correct Etiology for a Solid Pancreatic Mass? A Meta-Analysis and Systematic Review

作者：Puli Srinivas R; Bechtold Matthew L; Buxbaum James L; Eloubeidi Mohamad A

来源：Pancreas, 2013, 42(1): 20-26.

DOI：10.1097/MPA.0b013e3182546e79

• meta-analysis
• endoscopic ultrasound
• systematic review
• pancreatic mass

Objectives: The objective of this study was to evaluate the accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in diagnosing the correct etiology for a solid pancreatic mass. %26lt;br%26gt;Method: Data extracted from EUS-FNA studies with a criterion standard (either confirmed by surgery or appropriate follow-up) were selected. Articles were searched in MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials %26 Database of Systematic Reviews. Pooling was conducted by both fixed- and random-effects models. %26lt;br%26gt;Results: Initial search identified 3610 reference articles, of these 360 relevant articles were selected and reviewed. Data were extracted from 41 studies (N = 4766) which met the inclusion criteria. Pooled sensitivity of EUS-FNA in diagnosing the correct etiology for solid pancreatic mass was 86.8% (95% confidence interval [CI], 85.5-87.9). Endoscopic ultrasound-guided FNA had a pooled specificity of 95.8% (95% CI, 94.6-96.7). Positive likelihood ratio of EUS was 15.2 (95% CI, 8.5-27.3), and the negative likelihood ratio was 0.17 (95% CI, 0.13-0.21). %26lt;br%26gt;Conclusions: Endoscopic ultrasound-guided FNA is an excellent diagnostic tool to detect the correct etiology for solid pancreatic masses. When available, EUS-FNA should be strongly considered as the first diagnostic tool for sampling these lesions to optimize patient management.

• 出版日期2013-1