未经证实:胸膜冷冻活检是一种诊断胸膜病变的新技术。然而,与胸膜活检的标准钳相比,这种方式的安全性和可行性尚未完全阐明。本系统综述和荟萃分析旨在确定冷冻活检用于评估未诊断的胸腔积液的有效性和安全性。
未经评估:对于本系统综述和荟萃分析,我们搜索了PubMed,Embase,Scopus,以及截至2021年12月16日的WebofScience数据库,以识别相关文章。我们纳入了随机对照试验,队列研究,回顾性研究和病例系列,比较胸膜冷冻活检和镊子活检。使用QUADAS-2工具进行定性评估。
UASSIGNED:在我们搜索确定的365篇文章中,15项研究符合纳入条件。与镊子活检相比,冷冻活检获得的标本尺寸明显更大(标准平均差1.16;95%CI:0.51-1.82;P<0.01)。此外,冷冻活检组织标本较深(OR2.68;95%CI:1.39-5.16;P<0.01),质量较好,挤压伪影较少(OR0.06;95%CI:0.01-0.26;P<0.01)。胸膜冷冻活检和产钳活检在诊断率(OR1.32;95%CI:0.79-2.21;P=0.29)和轻度至中度出血事件(OR1.21;95%CI:0.64-2.29;P=0.57)方面无显著差异。在这些研究中没有观察到发表偏倚。
UNASSIGNED:与柔性钳活检相比,胸膜冷冻活检获得了更大和更深的组织标本,挤压伪影更少,但没有显示诊断结果的优越性。还需要进一步的研究来验证这些发现。
UNASSIGNED: Pleural cryobiopsy is a novel technique for the diagnosis of pleural pathologies. However, the safety and feasibility of this modality compared to standard forceps for pleural biopsy has not been fully elucidated. This systematic review and meta-analysis aims to establish the efficacy and safety of cryobiopsy for evaluation of undiagnosed pleural effusion.
UNASSIGNED: For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and Web of science databases up to December 16, 2021 to identify relevant articles. We included randomized controlled trials, cohort studies, retrospectives studies and case series that compared pleural cryobiopsy and forceps biopsy. A qualitative assessment was performed using the QUADAS-2 tool.
UNASSIGNED: Of the 365 articles identified by our search, 15 studies were eligible for inclusion. The specimen sizes obtained with cryobiopsy were significantly larger compared with forceps biopsy (Standard mean difference 1.16; 95 % CI: 0.51-1.82; P < 0.01). Furthermore, the cryobiopsy tissue specimens were deeper (OR 2.68; 95 % CI: 1.39-5.16; P < 0.01) and qualitatively better with less crush artifacts (OR 0.06; 95 % CI: 0.01-0.26; P < 0.01). There was no significant difference in diagnostic yield (OR 1.32; 95 % CI: 0.79-2.21; P = 0.29) and mild to moderate bleeding events (OR 1.21; 95 % CI: 0.64-2.29; P = 0.57) between pleural cryobiopsy and forceps biopsy. No publication bias was observed among these studies.
UNASSIGNED: Compared to flexible forceps biopsy pleural cryobiopsy obtained larger and deeper tissue specimens with less crush artifacts but does not show superiority for diagnostic yield. Further studies are still needed to verify these findings.