Endoscopic Ultrasonography-Guided Biopsy for Differentiation of Benign and Malignant Pelvic Lesions: A Systematic Review and Meta-Analysis.
BACKGROUND
Preoperative diagnosis of pelvic lesions remains challenging despite advances in imaging technologies. Endoscopic ultrasonography (EUS)-guided biopsy is an effective diagnostic modality for sampling the digestive tract and surrounding areas. However, a meta-analysis summarizing the diagnostic efficacy of EUS-guided biopsy for pelvic lesions has not been published.


OBJECTIVE
We aimed to evaluate the utility of EUS-guided biopsy in the diagnosis of pelvic lesions.


METHODS
Articles were identified via structured database search; only studies where pelvic lesions were confirmed by surgery or clinical follow-up were included. Data extracted were selected with strict criteria. A fixed-effects model was used to estimate the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). A summary receiver operating characteristic curve (SROC) was also constructed.


RESULTS
Ten studies containing a total of 246 patients were included. The pooled sensitivity of EUS-guided biopsy for differential diagnosis of pelvic masses was 0.89 (95% CI 0.83-0.94), and the specificity was 0.93 (95% CI 0.86-0.97). The area under the SROC was 0.9631. The combined PLR, NLR, and DOR were 11.75 (95% CI 5.90-23.43), 0.12 (95% CI 0.07-0.20), and 100.06 (95% CI 37.48-267.10) respectively. There is potential presence of publication bias in this meta-analysis.


CONCLUSIONS
Our meta-analysis shows that EUS-guided biopsy is a powerful tool for differentiating pelvic masses with a high sensitivity and specificity. Furthermore, it is a safe procedure with low rate of complication, although more high-quality prospective studies are required to be done.
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. 271914799@qq.com.
Chaoqun
C
Han
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. selinalin35@hotmail.com.
Rong
R
Lin
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. liujun_99@126.com.
Jun
J
Liu
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. houxh@medmail.com.cn.
Xiaohua
X
Hou
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. qianwei63@126.com.
Wei
W
Qian
Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. docd720@126.com.
Zhen
Z
Ding
D001706:Biopsy; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000473:pathology*; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis / Q000473:pathology; D041981:Gastrointestinal Tract / Q000473:pathology*; D006801:Humans; D018084:Ultrasonography, Interventional
Biopsy; Endoscopic ultrasound; Meta-analysis; Pelvic lesion