Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: A meta-analysis of randomized controlled trials

Hong Li, Wei Li, Qiu-Yuan Zhou, Bin Fan, Hong Li, Wei Li, Qiu-Yuan Zhou, Bin Fan

Abstract

Background: The comparison between endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) and EUS guided fine needle biopsy (FNB) in sampling pancreatic masses is still controversial.

Methods: A systematic search was conducted in PubMed and Web of Science to identify all relevant randomized controlled trials (RCTs). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for dichotomous outcomes of interest (specimen adequacy, diagnostic accuracy, complications, and technical success), while mean difference (MD) and 95% CI were pooled for continuous variables (number of needle passes required for diagnosis).

Results: Eleven RCTs were identified with a total of 694 EUS-FNA cases and 688 EUS-FNB cases. Compared with EUS-FNA, EUS-FNB had a better specimen adequacy (OR: 1.83, 95% CI: 1.27-2.64), higher diagnostic accuracy (OR: 1.62, 95% CI: 1.17-2.26), and fewer number of needle passes (MD: 0.69, 95% CI: 1.18 to 0.20). No significant difference was found in complications (OR: 1.01, 95% CI: 0.27-3.78) and technical success (OR: 0.13, 95% CI: 0.02-1.07).

Conclusion: EUS-FNB is superior to EUS-FNA in sampling pancreatic masses.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Forrest plot for specimen adequacy between FNA and FNB in sampling pancreatic masses. FNA = fine needle aspiration, FNB = fine needle biopsy.
Figure 2
Figure 2
Forrest plot for diagnostic accuracy between FNA and FNB in sampling pancreatic masses. FNA = fine needle aspiration, FNB = fine needle biopsy.
Figure 3
Figure 3
Forrest plot for number of needle passes required for diagnosis between FNA and FNB in sampling pancreatic masses. FNA = fine needle aspiration, FNB = fine needle biopsy.
Figure 4
Figure 4
Forrest plot for complications between FNA and FNB in sampling pancreatic masses. FNA = fine needle aspiration, FNB = fine needle biopsy.
Figure 5
Figure 5
Forrest plot for technical success between FNA and FNB in sampling pancreatic masses. FNA = fine needle aspiration, FNB = fine needle biopsy.

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