title: Diagnostic efficacy of endoscopic ultrasound-guided needle sampling for upper gastrointestinal subepithelial lesions: a meta-analysis.
abstract: An increasing number of studies have been conducted on the use of endoscopic ultrasound (EUS)-guided needle sampling for upper gastrointestinal subepithelial lesions (SEL). However, reported diagnostic efficacy varies greatly.
  
  
  
  To summarize up current evidences on the diagnostic efficacy of EUS-guided needle sampling for upper GI SEL.
  
  
  
  A reproducible strategy was used to search four databases. Search results were evaluated for eligibility, and the quality of eligible studies was assessed by QUADAS-2. Pooled efficacy of EUS-guided needle sampling in upper GI SEL was calculated. Procedure-related complications, diagnostic errors, and independent factors related to a higher success rate were also recorded and analyzed.
  
  
  
  Seventeen studies, comprising 978 attempts of EUS-guided needle sampling, were included in a meta-analysis. Pooled diagnostic rate of EUS-guided needle sampling was 59.9 %, with a heterogeneity I (2) of 55.2 %. Subgroup analysis showed no difference in diagnostic rate among fine needle aspiration (FNA), trucut needle biopsy (TCB), and fine needle biopsy (FNB), or among 19-, 22-, and 25-G needles. Subgroup analysis and meta-regression suggested that the cell block method might be correlated with a higher diagnostic rate. Few severe complications were reported. Diagnosis errors were rare.
  
  
  
  EUS-guided needle sampling is a safe, but only moderately effective method for pathology diagnosis of upper GI SEL. Choice of FNA/TCB/FNB, or 19 G/22 G/25 G does not seem to alter the overall diagnostic rate.
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Xiao-Cen
authors: XC
authors: Zhang
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Quan-Lin
authors: QL
authors: Li
authors: Section for Epidemiology, Department of Public Health, Aarhus University, Aarhus, Denmark.
authors: Yong-Fu
authors: YF
authors: Yu
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Li-Qing
authors: LQ
authors: Yao
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Mei-Dong
authors: MD
authors: Xu
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Yi-Qun
authors: YQ
authors: Zhang
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Yun-Shi
authors: YS
authors: Zhong
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China.
authors: Wei-Feng
authors: WF
authors: Chen
authors: Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, 180 FengLin Road, Shanghai, 200032, People's Republic of China. zhou.pinghong@zs-hospital.sh.cn.
authors: Ping-Hong
authors: PH
authors: Zhou
mesh_terms: D001707:Biopsy, Needle / Q000379:methods; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D019160:Endosonography / Q000379:methods; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D009339:Needles; D013048:Specimen Handling; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology*
keywords: Biopsy, needle; Diagnosis; Endosonography; Subepithelial lesion