PDF(Pubmed)
Abstract：
BACKGROUND: The efficacy of endoscopic ultrasound-guided liver biopsy (EUS-LB) compared to percutaneous liver biopsy (PC-LB) remains uncertain.
METHODS: Our data consist of randomized controlled trials (RCTs) comparing EUS-LB to PC-LB, found through a literature search via PubMed/Medline and Embase. The primary outcome was sample adequacy, whereas secondary outcomes were longest and total lengths of tissue specimens, diagnostic accuracy, and number of complete portal tracts (CPTs).
RESULTS: Sample adequacy did not significantly differ between EUS-LB and PC-LB (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.58-2.38; p = 0.65), with very low evidence quality and inadequate sample size as per trial sequential analysis (TSA). The two techniques were equivalent with respect to diagnostic accuracy (RR: 1; CI: 0.95-1.05; p = 0.88), mean number of complete portal tracts (mean difference: 2.29, -4.08 to 8.66; p = 0.48), and total specimen length (mean difference: -0.51, -20.92 to 19.9; p = 0.96). The mean maximum specimen length was significantly longer in the PC-LB group (mean difference: -3.11, -5.51 to -0.71; p = 0.01), and TSA showed that the required information size was reached.
CONCLUSIONS: EUS-LB and PC-LB are comparable in terms of diagnostic performance although PC-LB provides longer non-fragmented specimens.
METHODS: Our data consist of randomized controlled trials (RCTs) comparing EUS-LB to PC-LB, found through a literature search via PubMed/Medline and Embase. The primary outcome was sample adequacy, whereas secondary outcomes were longest and total lengths of tissue specimens, diagnostic accuracy, and number of complete portal tracts (CPTs).
RESULTS: Sample adequacy did not significantly differ between EUS-LB and PC-LB (risk ratio [RR] 1.18; 95% confidence interval [CI] 0.58-2.38; p = 0.65), with very low evidence quality and inadequate sample size as per trial sequential analysis (TSA). The two techniques were equivalent with respect to diagnostic accuracy (RR: 1; CI: 0.95-1.05; p = 0.88), mean number of complete portal tracts (mean difference: 2.29, -4.08 to 8.66; p = 0.48), and total specimen length (mean difference: -0.51, -20.92 to 19.9; p = 0.96). The mean maximum specimen length was significantly longer in the PC-LB group (mean difference: -3.11, -5.51 to -0.71; p = 0.01), and TSA showed that the required information size was reached.
CONCLUSIONS: EUS-LB and PC-LB are comparable in terms of diagnostic performance although PC-LB provides longer non-fragmented specimens.
摘要：
背景：与经皮肝活检（PC-LB）相比，内镜超声引导肝活检（EUS-LB）的疗效仍不确定。
方法：我们的数据包括比较EUS-LB和PC-LB的随机对照试验（RCT），通过PubMed/Medline和Embase的文献检索找到。主要结果是样本充足，而次要结局是组织标本的最长和总长度，诊断准确性,以及完整门户区域(CPT)的数量。
结果：EUS-LB和PC-LB之间的样本充分性没有显着差异（风险比[RR]1.18;95％置信区间[CI]0.58-2.38;p=0.65），根据试验序贯分析（TSA），证据质量非常低，样本量不足。两种技术在诊断准确性方面是等效的（RR：1；CI：0.95-1.05；p=0.88），完整门户道的平均数量（平均差：2.29，-4.08至8.66；p=0.48），和标本总长度（平均差：-0.51，-20.92至19.9；p=0.96）。PC-LB组的平均最大标本长度明显更长（平均差：-3.11，-5.51至-0.71；p=0.01），TSA显示达到了所需的信息大小。
结论：EUS-LB和PC-LB在诊断性能方面具有可比性，尽管PC-LB提供了更长的非碎片标本。
方法：我们的数据包括比较EUS-LB和PC-LB的随机对照试验（RCT），通过PubMed/Medline和Embase的文献检索找到。主要结果是样本充足，而次要结局是组织标本的最长和总长度，诊断准确性,以及完整门户区域(CPT)的数量。
结果：EUS-LB和PC-LB之间的样本充分性没有显着差异（风险比[RR]1.18;95％置信区间[CI]0.58-2.38;p=0.65），根据试验序贯分析（TSA），证据质量非常低，样本量不足。两种技术在诊断准确性方面是等效的（RR：1；CI：0.95-1.05；p=0.88），完整门户道的平均数量（平均差：2.29，-4.08至8.66；p=0.48），和标本总长度（平均差：-0.51，-20.92至19.9；p=0.96）。PC-LB组的平均最大标本长度明显更长（平均差：-3.11，-5.51至-0.71；p=0.01），TSA显示达到了所需的信息大小。
结论：EUS-LB和PC-LB在诊断性能方面具有可比性，尽管PC-LB提供了更长的非碎片标本。
