Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis
Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis
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超声内镜引导下针取样对上消化道上皮下病变诊断效果的荟萃分析
DOI：
10.1007/s00464-015-4494-1
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发表时间：
2016-06-01
影响因子：
3.1
通讯作者：
Zhou, Ping-Hong
中科院分区：
文献类型：
--
作者：
Zhang, Xiao-Cen;Li, Quan-Lin;Zhou, Ping-Hong
背景越来越多的研究已经进行了使用内镜超声（EUS）引导下的上消化道上皮下病变（SEL）的穿刺取样。目的总结EUS引导下穿刺活检对上消化道SEL. Methods诊断有效性的现有证据，采用可重复性策略检索4个数据库。评价检索结果的合格性，并通过QUADAS-2评估合格研究的质量。计算了EUS引导下上消化道SEL穿刺取样的合并有效性。程序相关的并发症，诊断错误，和独立的因素相关的一个更高的成功率也被记录和analyzed.ResultsSeventeen研究，包括978尝试EUS引导针采样，被列入荟萃分析。EUS引导下穿刺取样的合并诊断率为59.9%，异质性I2为55.2%。亚组分析显示，细针穿刺（FNA）、Trucut针活检（TCB）和细针活检（FNB）之间或19-G、22-G和25-G针之间的诊断率无差异。亚组分析和荟萃回归分析表明，细胞块法可能与较高的诊断率。报告了少数严重并发症。结论EUS引导下穿刺活检是一种安全、有效的上消化道SEL的病理诊断方法，选择FNA/TCB/FNB或19 G/22 G/25 G并不影响诊断率。
BackgroundAn increasing number of studies have been conducted on the use of endoscopic ultrasound (EUS)-guided needle sampling for upper gastrointestinal subepithelial lesions (SEL). However, reported diagnostic efficacy varies greatly.ObjectiveTo summarize up current evidences on the diagnostic efficacy of EUS-guided needle sampling for upper GI SEL.MethodA reproducible strategy was used to search four databases. Search results were evaluated for eligibility, and the quality of eligible studies was assessed by QUADAS-2. Pooled efficacy of EUS-guided needle sampling in upper GI SEL was calculated. Procedure-related complications, diagnostic errors, and independent factors related to a higher success rate were also recorded and analyzed.ResultsSeventeen studies, comprising 978 attempts of EUS-guided needle sampling, were included in a meta-analysis. Pooled diagnostic rate of EUS-guided needle sampling was 59.9 %, with a heterogeneityI2of 55.2 %. Subgroup analysis showed no difference in diagnostic rate among fine needle aspiration (FNA), trucut needle biopsy (TCB), and fine needle biopsy (FNB), or among 19-, 22-, and 25-G needles. Subgroup analysis and meta-regression suggested that the cell block method might be correlated with a higher diagnostic rate. Few severe complications were reported. Diagnosis errors were rare.ConclusionEUS-guided needle sampling is a safe, but only moderately effective method for pathology diagnosis of upper GI SEL. Choice of FNA/TCB/FNB, or 19 G/22 G/25 G does not seem to alter the overall diagnostic rate.