title: How good is endoscopic ultrasound-guided fine-needle aspiration in diagnosing the correct etiology for a solid pancreatic mass?: A meta-analysis and systematic review.
abstract: OBJECTIVE
  The objective of this study was to evaluate the accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in diagnosing the correct etiology for a solid pancreatic mass.
  
  
  METHODS
  Data extracted from EUS-FNA studies with a criterion standard (either confirmed by surgery or appropriate follow-up) were selected. Articles were searched in MEDLINE, CINAHL, and Cochrane Central Register of Controlled Trials & Database of Systematic Reviews. Pooling was conducted by both fixed- and random-effects models.
  
  
  RESULTS
  Initial search identified 3610 reference articles, of these 360 relevant articles were selected and reviewed. Data were extracted from 41 studies (N = 4766) which met the inclusion criteria. Pooled sensitivity of EUS-FNA in diagnosing the correct etiology for solid pancreatic mass was 86.8% (95% confidence interval [CI], 85.5-87.9). Endoscopic ultrasound-guided FNA had a pooled specificity of 95.8% (95% CI, 94.6-96.7). Positive likelihood ratio of EUS was 15.2 (95% CI, 8.5-27.3), and the negative likelihood ratio was 0.17 (95% CI, 0.13-0.21).
  
  
  CONCLUSIONS
  Endoscopic ultrasound-guided FNA is an excellent diagnostic tool to detect the correct etiology for solid pancreatic masses. When available, EUS-FNA should be strongly considered as the first diagnostic tool for sampling these lesions to optimize patient management.
authors.affiliation: Division of Gastroenterology and Hepatology, Massachusetts General Hospital and Brigham Women's Hospital, Harvard School of Medicine, Boston, MA, USA. srinivaspuli@yahoo.com
authors.forename: Srinivas R
authors.initials: SR
authors.lastname: Puli
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Bechtold
authors.forename: James L
authors.initials: JL
authors.lastname: Buxbaum
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Eloubeidi
mesh_terms: D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D006801:Humans; D016013:Likelihood Functions; D016017:Odds Ratio; D010179:Pancreas / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000209:etiology / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity