1Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
2Endoscopy Unit, Department of Gastroenterology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
Copyright © 2020 Korean Society of Gastrointestinal Endoscopy
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest: Marvin Ryou is a consultant for Olympus and Medtronic, Eduardo Guimarães Hourneaux de Moura is a consultant for Boston Scientific and Olympus, Christopher C. Thompson is consultant for Boston Scientific, Olympus and Medtronic. The other authors have no financial conflicts of interest.
Author Contributions
Conceptualization: Diogo Turiani Hourneax de Moura
Data curation: DTHM, Igor Braga Ribeiro
Formal analysis: Wanderlei Marques Bernardo
Methodology: DTHM, WMB, Eduardo Guimarães Hourneaux de Moura
Project administration: EGHM, WMB
Supervision: EGHM, Christopher C. Thompson
Writing-original draft: DTHM
Writing-review&editing: Marvin Ryou, CCT
Study | Patients (n) | Age (yr) | Lesion size | Intervention | Gold standard | Final diagnosis |
---|---|---|---|---|---|---|
Jo et al. (2019) [9] | 263 | 64.6±10.5 | 26.9±11.6 mm | EUS-FNA (22 G, 25H, 20 G and 19 G): 2.7 (±1.2) passes | 1) Surgical pathology; | Malignant: 239 |
M: 167 | 2) pathologic diagno- sis made by any tissue acquisition method; 3) follow-up (>6 mo) | - Pancreatic mass: 163 | ||||
Design: Retrospective | F: 96 | ERCP: 3 (1–7) intraductal biopsy in 246/257 cases and cytology (via endoscopic nasobiliary drainage or brushing in all cases) | - CCA: 53 | |||
- Gallbladder cancer: 14 | ||||||
- Other: 9 | ||||||
Benign: 24 | ||||||
- Autoimmune pancreatitis: 12 | ||||||
- Chronic pancreatitis: 5 | ||||||
- Other: 7 | ||||||
Moura et al. (2018) [2] | 50 | 63.08 (41–86) | 3.48±1.72 cm | EUS-FNA (22 G): 4 passes | 1) Surgical pathology; | Malignant: 48 |
M: 24 | 2) clinical follow-up (>6 mo) | - Adenocarcinoma: 36 | ||||
Design: Prospective | F: 26 | ERCP: 3 intraductal biopsies and 2 brush cytology | - IPMN: 4 | |||
- Metastases: 3 | ||||||
- Neuroendocrine tumor: 2 | ||||||
- Adenosquamous: 1 | ||||||
Weilert et al. (2014) [3] | 51 | 67 (42–88) | N/A | EUS-FNA (22 G or 25 G)—with ROSE | 1) Surgical findings/pathology; 2) EUS or ERCP sampling with definite evidence for malignancy; and 3) clinical follow-up (>6 mo) | Malignant: 48 |
- Pancreatic cancer: 34 | ||||||
Design: Prospective | ERCP: 2 to 3 intraductal biopsies and brush cytology | - CCA: 13 | ||||
- Gallbladder cancer: 1 | ||||||
Benign: 3 | ||||||
- Autoimmune pancreatitis: 1 | ||||||
- Chronic pancreatitis: 1 | ||||||
- Autoimmune cholangiopathy: 1 | ||||||
Novis et al. (2010) [34] | 46 | 56 (40–87) | N/A | EUS-FNA (22 G): at least 3 passes-with ROSE (by the endoscopist) | 1) Surgical pathology; 2) EUS or ERCP sampling with evidence for malignancy; and 3) clinical follow-up (>6 mo for malignance and 24 mo for benign) | Malignant: 37 |
M: 21 | - Pancreatic cancer: 26 | |||||
Design: Prospective | F: 25 | ERCP brush cytology | - Biliary: 11 | |||
- Common bile duct: 8 | ||||||
- Hilar tumors: 3 | ||||||
Benign: 9 | ||||||
- Chronic pancreatitis: 8 | ||||||
- Fibrosis: 2 | ||||||
Oppong et al. (2010) [6] | 37 | 62.4 (26–87) | N/A | EUS-FNA (22 G and 25 G): 2.7 (1–6) passes | 1) Surgical histology or other biopsy methods; | Malignant: 32 |
- Pancreatic tumor: 29 | ||||||
Design: Retrospective | ERCP brush cytology: at least 3 brushings | 2) any positive cytology result combined with clinical follow-up with evidence of malignancy; 3) follow-up until death or for at least two years if there was no evidence of malignancy | - Neuroendocrine tumor: 2 | |||
- CCA: 1 | ||||||
Benign: 5 | ||||||
- Chronic pancreatitis: 2 | ||||||
- Primary sclerosing cholangitis: 1 | ||||||
- Serous cyst adenoma: 1 | ||||||
- GIST: 1 | ||||||
Rösch et al. (2004) [5] | 50 | N/A | N/A | EUS-FNA (22 G): at least 2 passes | 1) Surgery pathology | Malignant: 28 |
M: 29 | ERCP: 6 intraductal biopsies and brush cytology (2 types of brush, 2 passes with each) | 2) Biopsy specimens obtained by other methods | - Pancreatic tumors: 16 | |||
Design: Prospective | F: 21 | 3) A positive result for any tissue acquisition method being evaluated, plus clinical follow-up that provided further evidence of malignancy | - Biliary tumors: 12 (8 common bile duct and 4 hilar) | |||
4) Further evidence of malignancy (e.g., distant metastases) | Benign: 22 | |||||
- Chronic pancreatitis 6 | ||||||
5) 6-mo follow-up | - CBD stricture: 16 (9 common bile duct and 7 hilar) |
Study |
Risk of bias |
Applicability concerns |
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Patient selection | Index test | Reference standard | Flow and timing | Patient selection | Index test | Reference standard | |
Jo et al. (2019) [9] |
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Moura et al. (2018) [2] |
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Weilert et al. (2014) [3] |
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Novis et al. (2010) [34] |
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Oppong et al. (2010) [6] |
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Rösch et al. (2004) [5] |
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Study | Patients, n | Adverse events, n(%) | Adverse events |
---|---|---|---|
Jo et al. (2019) [9] | 263 | 24 (9.12) | - 8 bleedings |
- 2 cholangitis | |||
- 14 pancreatitis | |||
Moura et al. (2018) [2] | 50 | 3 (6) | - 2 mild pancreatitis |
- 1 post sphincterotomy bleeding without hemodynamic repercussion, treated endoscopically | |||
Weilert et al. (2014) [3] | 51 | 0 | No adverse events |
Novis et al. (2010) [34] | 46 | 5 (10.86) | - 2 cholangitis treated endoscopically |
- 1 mild pancreatitis | |||
- 1 biliary peritonitis. Surgical intervention was required. Patient died after surgery | |||
- 1 mild bleeding. No intervention was required | |||
Oppong et al. (2010) [6] | 37 | 2 (9.1) | - 1 mild pancreatitis |
- 1 inadequate biliary drainage after procedures. Stent exchange was required | |||
Rösch et al. (2004) [5] | 50 | 0 | No adverse events |