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Medline ® Abstract for Reference 46

of '超声内镜在外分泌胰腺癌分期中的应用'

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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.
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Puli SR, Bechtold ML, Buxbaum JL, Eloubeidi MA
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Pancreas. 2013;42(1):20.
 
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.
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&Database of Systematic Reviews. Pooling was conducted by both fixed- and random-effects models.
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).
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.
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Division of Gastroenterology and Hepatology, Massachusetts General Hospital and Brigham Women's Hospital, Harvard School of Medicine, Boston, MA, USA. srinivaspuli@yahoo.com
PMID