Abstract：
Objective: To quantitatively compare the diagnostic value of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) in solid pancreatic mass lesions using a systematic evaluation method.Methods: A systematic literature search was conducted on public databases to include studies comparing the diagnostic value of EUS-FNA and EUS-FNB in solid pancreatic mass lesions. The combined effect size was estimated using mean difference (MD) and risk difference (RD) respectively, and the corresponding 95% confidence interval (CI) was calculated.Results: The 12 articles (7 RCTs and 5 cohort studies) met the inclusion criteria of this study. The meta-analysis showed that compared with EUS-FNB, EUS-FNA had lower diagnostic accuracy (RD: -0.08, 95% CI: -0.15, -0.01) and specimen adequacy (RD: -0.08, 95% CI: -0.15, -0.02), while higher required number of needle passes (MD: 0.42, 95% CI: 0.12, 0.73). However, EUS-FNB and EUS-FNA presented similar overall complications (RD: 0.00, 95% CI: -0.01, 0.02) and technical failures (RD: -0.01, 95% CI: -0.02, 0.00), without statistically significant differences.Conclusions: Compared with EUS-FNA, EUS-FNB seems to be a better choice for diagnosing suspected pancreatic lesions.
摘要：
目的:采用系统评价方法定量比较超声内镜引导下细针穿刺活检(EUS-FNA)和超声内镜引导下细针穿刺活检(EUS-FNB)对胰腺实性肿块病变的诊断价值。方法：在公共数据库上进行系统的文献检索，包括比较EUS-FNA和EUS-FNB在胰腺实性肿块性病变中的诊断价值的研究。综合效应大小分别用平均差(MD)和风险差(RD)估计,计算相应的95%置信区间(CI)。结果:12篇文献(7篇随机对照试验和5篇队列研究)符合本研究的纳入标准。Meta分析显示,与EUS-FNB相比,EUS-FNA具有较低的诊断准确性（RD：-0.08，95％CI：-0.15，-0.01）和标本充分性（RD：-0.08，95％CI：-0.15，-0.02），而所需的针头通过次数较高（MD：0.42，95％CI：0.12，0.73）。然而,EUS-FNB和EUS-FNA表现出相似的总体并发症（RD：0.00，95％CI：-0.01，0.02）和技术故障（RD：-0.01，95％CI：-0.02，0.00），没有统计学上的显著差异。结论:与EUS-FNA相比,EUS-FNB似乎是诊断可疑胰腺病变的更好选择。
