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

1 Department of Medical Sciences, Gastroenterology Unit, University of Foggia, Foggia, Italy
2 Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, Himachal Pradesh, India
3 Department of Public Health, Sardar Patel Institute Campus, Ahmedabad, Gujarat, India

Correspondence Address:
Antonio Facciorusso,
Department of Medical Sciences, Gastroenterology Unit, University of Foggia, AOU Ospedali Riuniti, Viale Pinto, 1, Foggia 71100, Italy
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/eus.eus_4_19

PMID: 31031330

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.

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