不同内镜技术对上部胃肠道亚皮质病变组织采样的比较诊断产量:一个网络元分析
Antonio Facciorusso1, Stefano Francesco Crinò2, Alessandro Fugazza3,4
1Gastroenterology Unit, Department of Surgical and Medical Sciences, University of Foggia, Foggia, Italy.
Endoscopy
|August 17, 2023
概括
与其他方法相比,内镜超声波引导细针活检 (EUS-FNB) 和粘膜切口辅助活检 (MIAB) 为亚皮质病变提供了优越的诊断性能. 对于较小的病变,MIAB特别有效,而EUS-FNA在现场快速评估方面具有竞争力.
科学领域:
- 胃肠病学 胃肠病学
- 内镜检查是指内镜检查.
- 诊断技术 诊断技术
背景情况:
- 仅有有限的证据可以比较内镜组织采样对子皮质病变的比较.
- 为了弥补这一差距,进行了系统审查和网络元分析.
研究的目的:
- 为了比较各种内镜组织采样技术的诊断性能.
- 为了评估样本的充分性和诊断的准确性,用于subpepithelial病变.
主要方法:
- 随机对照试验 (RCT) 的系统文献综述.
- 咬对咬活检,粘膜切口辅助活检 (MIAB),内镜超声波引导细针吸收 (EUS-FNA) 和EUS引导细针活检 (EUS-FNB) 的比较.
- 使用相对风险 (RR) 和95%置信区间 (CI) 分析样本充分性和诊断准确性.
主要成果:
- 与EUS-FNA相比,EUS-FNB显示出更高的样本充分性 (RR 1.20).
- 咬对咬活检的结果低于EUS-FNB (RR 0.55) 的结果.
- 与EUS-FNA相比,MIAB在20毫米以下的病变中表现出更高的准确性 (RR 1.68).
- 总体而言,EUS-FNB (SUCRA 0.90) 和MIAB (SUCRA 0.83) 的表现优于其他技术.
结论:
- 对于亚皮质病变,EUS-FNB和MIAB提供了更好的性能.
- 对于较小的病变 (<20毫米),MIAB是首选的技术.
- 当现场快速细胞学评估 (ROSE) 有时,EUS-FNA仍然是一个可行的选择.
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