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Endosc Ultrasound. 2019 Apr 26. doi: 10.4103/eus.eus_4_19. [Epub ahead of print]

Comparison between 22G aspiration and 22G biopsy needles for EUS-guided sampling of pancreatic lesions: A meta-analysis.

Author information

1
Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy.
2
Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India.
3
Department of Public Health, Sardar Patel Institute Campus, Ahmedabad, Gujarat, India.

Abstract

Background and Objective:

Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles.

Materials and Methods:

Computerized bibliographic search on the main databases was performed and restricted to only randomized controlled trials. Summary estimates were expressed regarding risk ratio (RR) and 95% confidence interval.

Results:

A total of 11 trials with 833 patients were analyzed. The two needles resulted comparable in terms of diagnostic accuracy (RR 1.02, 0.97-1.08; P = 0.46), sample adequacy (RR 1.01, 0.96-1.06; P = 0.61), and histological core procurement (RR 1.01, 0.89-1.15; P = 0.86). Pooled sensitivity in the diagnosis of pancreatic cancer was 93.1% (87.9%-98.4%) and 90.4% (86.3%-94.5%) with biopsy and aspirate, respectively, whereas specificity for detecting pancreatic cancer was 100% with both needles. Analysis of the number of needle passes showed a nonsignificantly positive trend in favor of FNB (mean difference: -0.32, -0.66-0.02; P = 0.07).

Conclusion:

Our meta-analysis stands for a nonsuperiority of 22G FNB over 22G FNA; hence, no definitive recommendations on the use of a particular device can be made.

KEYWORDS:

Accuracy; EUS; FNA; fine-needle biopsy; pancreas; sensitivity

PMID:
31031330
DOI:
10.4103/eus.eus_4_19

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