评估胰腺神经内分泌肿瘤的内镜超声引导下细针采集:一项 Meta 分析。

IF 2.8 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Xiaohua Ye, Hongjun Hua, Chunxiao Hu, Jianying Dai, Chenjiao Wu, Jiaping Huai, Zhe Shen
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引用次数: 0

摘要

目的:本荟萃分析旨在评估EUS-FNA/B对泛NET患者的诊断效果:我们对 MEDLINE 和 Embase 数据库进行了计算机检索,以确定相关文章。主要结果包括与手术标本相比,FNA/B样本的分级吻合率、诊断率和相关系数(Cohen's κ)。次要结果包括样本的充分性、平均通过次数和不良事件:最终纳入了 45 项研究,涉及 2978 名患者。EUS-FNA/B与手术分级的汇总吻合率为0.77(95% CI:0.73-0.80;I2=48.2%)。G1 亚组的吻合率明显更高(0.88,95% CI:0.84-0.91),而 G2 亚组的吻合率最低(0.59,95% CI:0.52-0.65;P <0.001)。FNA/B 取样的汇总诊断率为 0.83(95% CI:0.79-0.86;I2=63.3%)。此外,在样本充分性(FNB 为 0.93,FNA 为 0.81;P=0.007)和所需穿刺针数(FNB 为 2.53,FNA 为 3.32;P=0.013)方面,FNB 优于 FNA。此外,分级的总体一致程度为中等(κ=0.59,95% CI:0.49-0.68;I2=84.5%)。少数不良事件对患者预后影响较小(0.03,95% CI:0.02-0.05;I2=19.2%):EUS-FNA/B是诊断panNET并对其进行术前分级的可靠方法,与FNA相比,FNB表现更优。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Endoscopic Ultrasound-Guided Fine Needle Acquisition for Evaluation of Pancreatic Neuroendocrine Tumors: A Meta-Analysis.

Aims: The aim of this meta-analysis was to assess the diagnostic performance of EUS-FNA/B in patients with panNETs.

Methods: We conducted a computerized search of the MEDLINE and Embase databases to identify relevant articles. The primary outcomes involved grading concordance rate, diagnostic rate, and correlation coefficient (Cohen's κ) for FNA/B samples compared with surgical specimens. Secondary outcomes included sample adequacy, mean number of passes, and adverse events.

Results: Forty-five studies involving 2978 patients were finally included. The pooled concordance rate between EUS-FNA/B and surgical grading was 0.77 (95% CI: 0.73-0.80; I2=48.2%). A significantly higher level of concordance was observed in G1 subgroup (0.88, 95% CI: 0.84-0.91), whereas the G2 subgroup revealed the lowest level of agreement (0.59, 95% CI: 0.52-0.65; P < 0.001). Pooled diagnostic rate for FNA/B sampling was 0.83 (95% CI: 0.79-0.86; I2=63.3%). In addition, FNB outperformed FNA in terms of sample adequacy (0.93 for FNB vs. 0.81 for FNA; P=0.007) and number of needle passes required (2.53 for FNB vs. 3.32 for FNA; P=0.013). Moreover, the overall level of agreement for grading was moderate (κ=0.59, 95% CI: 0.49-0.68; I2=84.5%). There were a limited number of adverse events that had minor influence on patient outcomes (0.03, 95% CI: 0.02-0.05; I2=19.2%).

Conclusions: EUS-FNA/B is a reliable approach for the diagnosis and preoperative grading of panNET, with FNB demonstrating superior performance compared with FNA.

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来源期刊
Journal of clinical gastroenterology
Journal of clinical gastroenterology 医学-胃肠肝病学
CiteScore
5.60
自引率
3.40%
发文量
339
审稿时长
3-8 weeks
期刊介绍: Journal of Clinical Gastroenterology gathers the world''s latest, most relevant clinical studies and reviews, case reports, and technical expertise in a single source. Regular features include cutting-edge, peer-reviewed articles and clinical reviews that put the latest research and development into the context of your practice. Also included are biographies, focused organ reviews, practice management, and therapeutic recommendations.
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