Abstract：
There is limited evidence on the incidence of needle tract seeding (NTS) in patients undergoing endoscopic ultrasound (EUS) tissue acquisition (TA) of pancreatic lesions. This meta-analysis aimed to assess the incidence of NTS after EUS-TA. With a search of the literature up until April 2022, we identified 10 studies (13,238 patients) assessing NTS incidences in patients undergoing EUS-TA. The primary outcome was NTS incidence. The secondary outcome was a comparison in terms of peritoneal carcinomatosis incidence between patients who underwent EUS-TA and non-sampled patients. Results were expressed as pooled rates or odds ratio (OR) and 95% confidence intervals (CI). The pooled rate of NTS was 0.3% (95% CI 0.2-0.4%), with no evidence of heterogeneity (I2 = 0%). Subgroup analysis based on the type of sampled lesion confirmed this finding both in patients with pancreatic adenocarcinoma (0.4%, 0.2-0.6%) and in patients with cystic pancreatic lesions (0.3%, 0.1-0.5%). No difference in terms of metachronous peritoneal dissemination was observed between patients who underwent EUS-TA and non-sampled patients (OR 1.02, 0.72-1.46; p = 0.31), with evidence of low heterogeneity (I2 = 16%). Rates of NTS after EUS-TA are very low; therefore, EUS-TA could be safely performed in a pre-operative setting.
摘要：
在接受胰腺病变的内窥镜超声（EUS）组织采集（TA）的患者中，针道播种（NTS）的发生率的证据有限。这项荟萃分析旨在评估EUS-TA后NTS的发生率。通过搜索直到2022年4月的文献，我们确定了10项研究（13,238例患者）评估接受EUS-TA患者的NTS发生率。主要结果是NTS发生率。次要结果是比较接受EUS-TA的患者与非样本患者之间的腹膜癌发病率。结果表示为合并率或比值比（OR）和95％置信区间（CI）。NTS的合并率为0.3%(95%CI0.2-0.4%)，没有异质性的证据（I2=0%）。基于采样病变类型的亚组分析证实了这一发现，这两种方法都适用于胰腺腺癌患者（0.4%，0.2-0.6％）和胰腺囊性病变患者（0.3％，0.1-0.5%）。在接受EUS-TA的患者和未取样的患者之间观察到异时腹膜播散的差异（OR1.02，0.72-1.46；p=0.31），具有低异质性的证据(I2=16%)。EUS-TA后的NTS率非常低；因此，EUS-TA可以在术前设置中安全地进行。
