With the 12th highest incidence and a common late diagnostic at advanced stages, neoadjuvant therapies for pancreatic cancer are important, but they require a confirmed diagnosis. Being a diagnostic standard, the clarification of the clinical relevance of needle gauges is needed, as larger ones may retrieve more tissue for diagnostics, but may also increase the risk of complications. We performed a meta-analysis to compare the efficiency of the most commonly used 22-G and 25-G needles for EUS guided biopsy in solid pancreatic lesions. The MEDLINE (via PubMed), Embase, Cochrane (CENTRAL), and Scopus databases were searched with “EUS”, “needle”, “FNA”, “pancreas”, “prospective”, “22G”, and “25G” keywords. Mixed effects were assessed in the model, with a mean of 86% and a 95% confidence interval. Fourteen prospective studies that compared the efficiency of 22-G and 25-G biopsy needles in 508 and 524 lesions, respectively, were analyzed, along with 332 specimens biopsied using both needle sizes. The groups did not significantly differ in the outcomes. A low degree of heterogeneity was observed overall, except for specimen adequacy. Moreover, 22-G and 25-G needles have comparable safety and efficacy for focal pancreatic lesion biopsies without a high risk of complications.
胰腺癌发病率位居第12位，且常在晚期才被诊断，因此新辅助治疗至关重要，但需以确诊为前提。作为诊断标准，穿刺针规格的临床意义亟待明确，因为较大规格的针具虽能获取更多组织用于诊断，但也可能增加并发症风险。本研究通过荟萃分析比较超声内镜引导下实性胰腺病变活检中最常用的22G与25G穿刺针的效能。检索MEDLINE（通过PubMed）、Embase、Cochrane（CENTRAL）和Scopus数据库，关键词包括"EUS"、"needle"、"FNA"、"pancreas"、"prospective"、"22G"和"25G"。采用混合效应模型进行评估，平均效应量为86%，95%置信区间。共纳入14项前瞻性研究，分别对508处和524处病灶使用22G与25G活检针进行比较分析，同时纳入332例使用两种针具的活检标本。结果显示两组在主要结局指标上无显著差异。除标本充足率外，整体异质性较低。研究表明，22G与25G穿刺针在局灶性胰腺病变活检中具有相当的安全性和有效性，且均未呈现高并发症风险。
肿瘤(癌症)患者之家