简介:胰腺癌是第四种最致命的癌症。然而,需要注意的是,并非所有胰腺肿块都是原发性恶性肿瘤的信号.因此,必须建立正确的鉴别诊断,术前活检程序进一步支持的过程。这项荟萃分析旨在比较胰腺组织采样的两种微创活检方法的诊断性能:计算机断层扫描或超声引导的经皮活检,和内镜超声(EUS)引导下经十二指肠活检。方法:在MEDLINE和Scopus数据库中进行系统的文献检索。纳入的研究分析了两种活检方法的诊断性能,并使用诊断准确性研究质量评估-2工具评估偏倚风险.使用RevMan和MetaDisc软件包进行统计分析。结果:对结果进行统计分析,证明了经皮入路的优越性。具体来说,汇集的敏感性,特异性,LR+,经皮入路的LR-和DOR为0.896[95%CI:0.878-0.913],0.949[95%CI:0.892-0.981],9.70[95%CI:5.20-18.09],0.20[95%CI:0.12-0.32]和68.55[95%CI:32.63-143.98],分别。EUS引导活检的相应值为0.806[95%CI:0.775-0.834],0.955[95%CI:0.926-0.974],12.04[95%CI:2.67-54.17],0.24[95%CI:0.15-0.39]和52.56[95%CI:13.81-200.09],分别。然而,这种统计学上的优越性似乎还与经皮穿刺活检过程中更倾向于更大、更容易接近的肿瘤的选择偏倚有关.结论:简明,我们的荟萃分析表明经皮入路具有统计学优势.然而,选择最佳活检方法是复杂的,受患者和肿瘤特征等因素的影响,临床资源,和其他相关考虑。
Introduction: Pancreatic cancer ranks as the fourth deadliest form of cancer. However, it is essential to note that not all pancreatic masses signal primary malignancy. Therefore, it is imperative to establish the correct differential diagnosis, a process further supported by pre-operative
biopsy procedures. This meta-analysis aims to compare the diagnostic performance of two minimally invasive
biopsy approaches for pancreatic tissue sampling: percutaneous biopsies guided by computed tomography or ultrasound, and transduodenal biopsies guided by endoscopic ultrasound (EUS). Methods: A systematic literature search was conducted in the MEDLINE and Scopus databases. The included studies analyzed the diagnostic performance of the two
biopsy methods, and they were assessed for risk of bias using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Statistical analysis was carried out using the RevMan and MetaDisc software packages. Results: The statistical analysis of the results demonstrated the superiority of the percutaneous approach. Specifically, the pooled sensitivity, specificity, LR+, LR-and DOR for the percutaneous approach were 0.896 [95% CI: 0.878-0.913], 0.949 [95% CI: 0.892-0.981], 9.70 [95% CI: 5.20-18.09], 0.20 [95% CI: 0.12-0.32] and 68.55 [95% CI: 32.63-143.98], respectively. The corresponding values for EUS-guided biopsies were 0.806 [95% CI: 0.775-0.834], 0.955 [95% CI: 0.926-0.974], 12.04 [95% CI: 2.67-54.17], 0.24 [95% CI: 0.15-0.39] and 52.56 [95% CI: 13.81-200.09], respectively. Nevertheless, it appears that this statistical superiority is also linked to the selection bias favoring larger and hence more readily accessible tumors during percutaneous
biopsy procedures. Conclusions: Concisely, our meta-analysis indicates the statistical superiority of the percutaneous approach. However, selecting the optimal
biopsy method is complex, influenced by factors like patient and tumor characteristics, clinical resources, and other relevant considerations.