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Benjamin D. Renelus,Daniel S. Jamorabo,Iman Boston,William M. Briggs,John M. Poneros 대한소화기내시경학회 2021 Clinical Endoscopy Vol.54 No.2
Background/Aims: Studies comparing the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) andendoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for solid pancreatic lesions have been inconclusive with no clearsuperiority. The aim of this meta-analysis was to compare the diagnostic accuracy and safety between the two sampling techniques. Methods: We performed a systematic search of randomized controlled trials published between 2012 and 2019. The primaryoutcome was overall diagnostic accuracy. Secondary outcomes included adverse event rates, cytopathologic and histopathologicaccuracy, and the mean number of passes required to obtain adequate tissue between FNA and FNB needles. Fixed and randomeffect models with pooled estimates of target outcomes were developed. Results: Eleven studies involving 1,365 participants were included for analysis. When compared to FNB, FNA had a significantreduction in diagnostic accuracy (81% and 87%, p=0.005). In addition, FNA provided reduced cytopathologic accuracy (82% and89%, p=0.04) and an increased number of mean passes required compared to FNB (2.3 and 1.6, respectively, p<0.0001). There wasno difference in adverse event rate between FNA and FNB needles (1.8% and 2.3% respectively, p=0.64). Conclusions: FNB provides superior diagnostic accuracy without compromising safety when compared to FNA. FNB should bereadily considered by endosonographers when evaluating solid pancreatic masses.
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