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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Is there a difference between 19G core biopsy needle and 22G core biopsy needle in diagnosing the correct etiology? - A meta-analysis and systematic review
Manasa Kandula, Matthew L Bechtold, Kaninika Verma, Bhagat S Aulakh, Deepak Taneja, Srinivas R Puli
Manasa Kandula, Division of Internal Medicine, University of Illinois College of Medicine at Peoria, Peoria, IL 61614, United States
Matthew L Bechtold, Division of Gastroenterology and Hepatology, University of Missouri School of Medicine at Columbia, Columbia, MO 65211, United States
Kaninika Verma, Bhagat S Aulakh, Deepak Taneja, Illinois Lung and Critical Care Institute, University of Illinois College of Medicine at Peoria, Peoria, IL 61614, United States
Srinivas R Puli, Division of Gastroenterology and Hepatology, University of Illinois College of Medicine at Peoria, Peoria, IL 61614, United States
Author contributions: Kandula M contributed to acquisition of data, data interpretation and analysis, and drafted the article; Bechtold M, Aulakh BS and Taneja D analyzed the data; Verma K, Aulakh BS and Taneja D interpreted the data; Puli SR contributed to conception and design of the study, verification of statistical methods; Bechtold M, Verma K, Aulakh BS, Taneja D and Puli SR revised the article, and approved the final version of published manuscript.
Conflict-of-interest statement: The authors deny any conflict of interest.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Manasa Kandula, MD, Division of Internal Medicine, University of Illinois College of Medicine at Peoria, 530 NE Glen Oak Avenue, Peoria, IL 61614, United States. manasakandula14@gmail.com
Telephone: +1-309-6249400 Fax: +1-309-6242291
Received: June 6, 2016
Peer-review started: June 12, 2016
First decision: September 13, 2016
Revised: November 13, 2016
Accepted: December 13, 2016
Article in press: December 14, 2016
Published online: April 26, 2017
AIM
To compare the accuracy of endoscopic ultrasonography (EUS) 19G core biopsies and 22G core biopsies in diagnosing the correct etiology for a solid mass.
METHODS
Articles were searched in Medline, PubMed, and Ovid journals. Pooling was conducted by both fixed and random effects models.
RESULTS
Initial search identified 4460 reference articles for 19G and 22G, of these 670 relevant articles were selected and reviewed. Data was extracted from 6 studies for 19G (n = 289) and 16 studies for 22G (n = 592) which met the inclusion criteria. EUS 19G core biopsies had a pooled sensitivity of 91.6% (95%CI: 87.1-95.0) and pooled specificity of 95.9% (95%CI: 88.6-99.2), whereas EUS 22G had a pooled sensitivity of 83.3% (95%CI: 79.7-86.6) and pooled specificity of 64.3% (95%CI: 54.7-73.1). The positive likelihood ratio of EUS 19G core biopsies was 9.08 (95%CI: 1.12-73.66) and EUS 22G core biopsies was 1.99 (95%CI: 1.09-3.66). The negative likelihood ratio of EUS 19G core biopsies was 0.12 (95%CI: 0.07-0.24) and EUS 22G core biopsies was 0.25 (95%CI: 0.14-0.41). The diagnostic odds ratio was 84.74 (95%CI: 18.31-392.26) for 19G core biopsies and 10.55 (95% CI: 3.29-33.87) for 22G needles.
CONCLUSION
EUS 19G core biopsies have an excellent diagnostic value and seem to be better than EUS 22G biopsies in detecting the correct etiology for a solid mass.
Core tip: Management of pancreatic solid mass lesions relies greatly on accuracy of diagnosis of these lesions. Procore fine needle biopsy needles have been found to have a diagnostic accuracy comparable to, if not better than the standard needles in diagnosing the intestinal and extra-intestinal mass lesions. Amongst the Procore needles, the 19G and 22G Procore needles have both been shown to obtain good quality core tissue samples but both have unique characteristics of their own. This meta-analysis compares the feasibility and accuracy of 19G and 22G Procore needles in determining the diagnosis of solid mass lesions.
