Comparison between 22G aspiration and 22G biopsy needles for EUS-guided sampling of pancreatic lesions: A meta-analysis

• Published in: Endoscopic Ultrasound Vol. 9; no. 3; pp. 167 - 174
• Main Authors: Facciorusso, Antonio, Bajwa, Harshvardhan, Menon, Kavitha, Buccino, Vincenzo, Muscatiello, Nicola
• Format: Journal Article
• Language: English
• Published: China Wolters Kluwer India Pvt. Ltd 01.05.2020; Wolters Kluwer - Medknow
• Subjects: Review; FNA; Accuracy; EUS; sensitivity; fine-needle biopsy; pancreas
• ISSN: 2303-9027; 2226-7190
• DOI: 10.4103/eus.eus_4_19

Background and Objective: Robust data in favor of clear superiority of 22G fine-needle biopsy (FNB) over 22G FNA for an echoendoscopic-guided sampling of pancreatic masses are lacking. The objective of this study is to compare the diagnostic outcomes and sample adequacy of these two needles. Materials and Methods: Computerized bibliographic search on the main databases was performed and restricted to only randomized controlled trials. Summary estimates were expressed regarding risk ratio (RR) and 95% confidence interval. Results: A total of 11 trials with 833 patients were analyzed. The two needles resulted comparable in terms of diagnostic accuracy (RR 1.02, 0.97-1.08; P = 0.46), sample adequacy (RR 1.01, 0.96-1.06; P = 0.61), and histological core procurement (RR 1.01, 0.89-1.15; P = 0.86). Pooled sensitivity in the diagnosis of pancreatic cancer was 93.1% (87.9%-98.4%) and 90.4% (86.3%-94.5%) with biopsy and aspirate, respectively, whereas specificity for detecting pancreatic cancer was 100% with both needles. Analysis of the number of needle passes showed a nonsignificantly positive trend in favor of FNB (mean difference: −0.32, −0.66-0.02; P = 0.07). Conclusion: Our meta-analysis stands for a nonsuperiority of 22G FNB over 22G FNA; hence, no definitive recommendations on the use of a particular device can be made.