Contrast-enhanced EUS for differential diagnosis of pancreatic mass lesions: a meta-analysis - 20/07/12
, 1, Duan-min Hu, MD , 1, 2, Qi Zhu, MD, PhD 1, ⁎Reprint requests: Qi Zhu, MD, PhD, Department of Gastroenterology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, ChinaRiassunto |
Background |
Distinguishing pancreatic adenocarcinomas from other pancreatic masses remains challenging with current imaging techniques. Contrast-enhanced EUS further improved the efficacy of EUS to characterize pancreatic lesions.
Objective |
To assess the accuracy of contrast-enhanced EUS for diagnosing adenocarcinoma in patients with pancreatic masses by pooling data of existing trials.
Design |
We systematically searched the Medline, PubMed, Web of Science, Embase, and Cochrane Central Trials databases for relevant studies published. Meta-analysis was performed. Pooling was conducted in a fixed-effect model or a random-effects model.
Patients |
Twelve studies involving 1139 patients were included.
Intervention |
Contrast-enhanced EUS.
Main Outcome Measurements |
Meta-analysis and meta-regression analysis.
Results |
The pooled sensitivity of contrast-enhanced EUS for the differential diagnosis of pancreatic adenocarcinomas was 94% (95% CI, 0.91-0.95), and the specificity was 89% (95% CI, 0.85-0.92). The area under the curve under summary receiver operating characteristic was 0.9732. The pooled positive likelihood ratio was 8.09 (95% CI, 4.47-14.64), and the negative likelihood ratio was 0.08 (95% CI, 0.06-0.10). The subgroup analysis by exclusion of the outliers provided a sensitivity of 93% (95% CI, 0.91-0.95) and a specificity of 93% (95% CI, 0.89-0.95) for the differential diagnosis of pancreatic adenocarcinomas. The area under the curve under summary receiver operating characteristic was 0.9745.
Limitations |
A small number of studies met the inclusion criteria.
Conclusion |
Contrast-enhanced EUS is a promising, reliable modality for the differential diagnosis of pancreatic adenocarcinoma in patients with pancreatic mass lesions. The finding of a hypoenhanced lesion was a sensitive and accurate predictor of pancreatic adenocarcinomas. It seems to be a useful tool in clinical practice.
Il testo completo di questo articolo è disponibile in PDF.Abbreviations : AUC, CI, LR, QUADAS, SROC, UCAs
Mappa
| DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. |
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| If you would like to chat with an author of this article, you may contact Dr Zhu at zhuqi@medmail.com.cn. |
Vol 76 - N° 2
P. 301-309 - agosto 2012 Ritorno al numero
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