The role of ultrasound-guided tru-cut biopsy in ovarian cancer: a systematic review of its safety, adequacy, and accuracy with meta-analysis of diagnostic performance.

IF 4.2 3区医学 Q1 REPRODUCTIVE BIOLOGY

Journal of Ovarian Research Pub Date : 2025-07-29 DOI:10.1186/s13048-025-01739-7

Munachiso Iheme Ndukwe, Matteo Pavone, Dominik Habes, Nicolo Bizzarri, Martin Stepan, Petra Bretová, Floriana Mascilini, Dominik Karasek, Denisa Pohankova, Akaninyene Ubom, Jana Marie Havigerova, Jiri Haviger, Igor Sirak

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Abstract

Objectives: To analyze the safety, adequacy and accuracy of ultrasound-guided tru-cut biopsy in the diagnosis of ovarian cancer.

Methods: A systematic search of PubMed, Web of Science, and Scopus was conducted through June 2024. Studies meeting predefined criteria were included in the review. The quality of diagnostic accuracy studies was assessed using QUADAS-2. A meta-analysis was performed on studies reporting complete 2 × 2 diagnostic data.

Results: A total of 2,250 articles were initially screened, and after the removal of duplicates, 54 articles were deemed eligible for full-text assessment. Ultimately, 18 studies, comprising 1,867 patients who underwent ultrasound-guided tru-cut biopsy, were included in the systematic review. A total of 16 complications were reported across 1,898 biopsies performed in the included studies, resulting in a mean complication rate of 0.58% (95% CI: 0.187- 0.964%). Adequacy for histological and immunohistochemical examination after one attempt was reported in 16 studies, with a mean adequacy rate of 95.1% (95% CI: 92.69- 97.50%) and a median rate of 95.97%. Diagnostic accuracy was assessed in 13 studies, revealing a mean diagnostic accuracy of 95.54% (95% CI: 93.19- 97.89%) and a median of 97.48%.In the meta-analysis of 10 studies, pooled sensitivity was 98.6%, specificity 41.9%, positive predictive value (PPV) 99.0%, and negative predictive value (NPV) 47.2%, with high heterogeneity observed in specificity and NPV estimates.

Conclusions: Ultrasound guided tru-cut biopsy is a safe and effective diagnostic method, demonstrating a high adequacy rate for histological and immunohistochemical analysis. It shows excellent performance in confirming malignancy and supports preoperative decision making. To further define its role in the diagnostic pathway for ovarian cancer, additional prospective multicenter studies are needed-both to validate its reliability in negative cases and to ensure tissue adequacy for advanced molecular testing in the context of personalized medicine.

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超声引导下真切活检在卵巢癌中的作用：对其安全性、充分性和准确性进行系统评价，并对诊断性能进行meta分析。

目的：分析超声引导下真切活检诊断卵巢癌的安全性、充分性和准确性。方法：系统检索PubMed、Web of Science、Scopus数据库至2024年6月。符合预定标准的研究被纳入审查。使用QUADAS-2评估诊断准确性研究的质量。对报告完整2 × 2诊断数据的研究进行荟萃分析。结果：最初共筛选了2250篇文章，在去除重复后，54篇文章被认为符合全文评估的条件。最终，18项研究，包括1867例接受超声引导的真切活检的患者，被纳入系统评价。在纳入的研究中，共进行了1898次活检，共报告了16例并发症，平均并发症发生率为0.58% （95% CI: 0.187- 0.964%）。16项研究报告了一次尝试后组织学和免疫组织化学检查的充分性，平均充分率为95.1% (95% CI: 92.69- 97.50%)，中位充分率为95.97%。13项研究评估了诊断准确性，显示平均诊断准确率为95.54% (95% CI: 93.19- 97.89%)，中位数为97.48%。在10项研究的荟萃分析中，合并敏感性为98.6%，特异性为41.9%，阳性预测值（PPV）为99.0%，阴性预测值（NPV）为47.2%，特异性和NPV估计具有很高的异质性。结论：超声引导下真切活检是一种安全有效的诊断方法，组织学和免疫组织化学分析的充分率高。它在恶性肿瘤的诊断和术前决策方面表现优异。为了进一步确定其在卵巢癌诊断途径中的作用，还需要进行更多的前瞻性多中心研究，以验证其在阴性病例中的可靠性，并确保在个性化医疗背景下进行高级分子检测的组织充足性。

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来源期刊

Journal of Ovarian Research REPRODUCTIVE BIOLOGY-

CiteScore

6.20

自引率

2.50%

发文量

125

审稿时长

>12 weeks

期刊介绍： Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.