title: Endoscopic ultrasound-guided fine-needle aspiration biopsy in the evaluation of bile duct strictures and gallbladder masses: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Recently, there are very few research on endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of bile duct and gallbladder masses. The objective of this study was to assess the overall diagnostic accuracy of EUS-FNA in the evaluation of patients with bile duct strictures and gallbladder masses with a meta-analysis.
  
  
  METHODS
  The MEDLINE, EMBASE, Cancerlit and Cochrane Library, and other database, from January 1995 to July 2010, were searched for studies evaluating EUS-FNA accuracy. Meta-analysis methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio, summary receiver operating characteristic curves, and the Q* index.
  
  
  RESULTS
  A total of nine studies with 284 patients, who fulfilled all the inclusion criteria, were considered for the analysis. EUS-FNA had a pooled sensitivity of 0.84 (95% confidence interval: 0.78-0.88) and a pooled specificity of 1.00 (95% confidence interval: 0.94-1.00). Overall area under the curve was 0.9254, The Q* index was 0.8598 and the calculated diagnostic odds ratio was 75.1. No complications occurred.
  
  
  CONCLUSIONS
  EUS-FNA was an accurate and safe tool in the evaluation bile duct and gallbladder masses. High-quality prospective studies regarding EUS-FNA in the evaluation of patients with bile duct and gallbladder masses are still needed to be conducted.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Lian-Ming
authors.initials: LM
authors.lastname: Wu
authors.forename: Xiao-Xing
authors.initials: XX
authors.lastname: Jiang
authors.forename: Hai-Yan
authors.initials: HY
authors.lastname: Gu
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.forename: Ling-Hua
authors.initials: LH
authors.lastname: Lin
authors.forename: Xia
authors.initials: X
authors.lastname: Deng
authors.forename: Yan
authors.initials: Y
authors.lastname: Yin
authors.forename: Jian-Rong
authors.initials: JR
authors.lastname: Xu
mesh_terms: D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D001661:Biliary Tract Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D044963:Biopsy, Fine-Needle; D019160:Endosonography; D005704:Gallbladder / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans