BACKGROUND AND AIMS EUS-guided FNA (EUS-FNA) is the criterion standard for the diagnosis of solid pancreatic lesions. Several studies assessed the role of repeat EUS-FNA (rEUS-FNA) after an inconclusive examination. Our aim was to evaluate the pooled diagnostic accuracy of rEUS-FNA after a nondiagnostic result. METHODS We conducted systematic research on electronic databases (Medline, PubMed, EMBASE) and a meta-analysis to obtain pooled sensitivity, specificity, positive and negative likelihood ratio, and diagnostic odds ratio. A summary receiver operating characteristic curve was used to calculate area under the curve. Subgroup analysis was used to assess the role of rapid on-site evaluation (ROSE). RESULTS Twelve studies (505 patients) were included. Sensitivity was 77% (66%-86%), specificity 98% (78%-100%), and positive and negative predictive values 99% (98%-100%) and 61 (60%-63%), respectively. At 73% of disease prevalence (pretest probability), positive rEUS-FNA increased the disease probability to 99%, whereas a negative result decreased the disease probability to 39%. The sensitivity was 83% (64%-93%) and specificity 98% (80%-100%) when ROSE was available and 65% (57%-73%) and 94% (31%-100%) when not available. The number needed to diagnose was 1.2 (1.1-2.3) and 1.7 (1.4-8.3) in ROSE-positive and ROSE-negative cases, respectively. The number of correctly diagnosed cases increased from 6 (1-7) to 8 (4-9) of 10 patients without and with ROSE, respectively. CONCLUSIONS This study objectively substantiated the added value of rEUS-FNA for the diagnosis of solid pancreatic masses in cases of a previous nondiagnostic or inconclusive result. Moreover, our data suggested that ROSE may be beneficial in this setting, because it increased the proportion of definitive diagnoses.

中文翻译：

---

在未诊断或不确定的结果后重复进行胰腺肿块的EUS-FNA：系统评价和荟萃分析。

背景与目的EUS引导的FNA（EUS-FNA）是诊断实体胰腺病变的标准标准。在一项不确定的检查后，几项研究评估了重复EUS-FNA（rEUS-FNA）的作用。我们的目的是评估非诊断结果后rEUS-FNA的综合诊断准确性。方法我们对电子数据库（Medline，PubMed，EMBASE）进行了系统研究，并进行了荟萃分析，以获取综合的敏感性，特异性，正负似然比和诊断比值比。汇总的接收器工作特性曲线用于计算曲线下的面积。亚组分析用于评估快速现场评估（ROSE）的作用。结果共纳入十二项研究（505例患者）。敏感性为77％（66％-86％），特异性为98％（78％-100％），阳性和阴性预测值分别为99％（98％-100％）和61（60％-63％）。rEUS-FNA阳性占疾病患病率的73％（预先测验的概率），使患病的可能性增至99％，而阴性结果使患病的可能性降至39％。当可获得ROSE时，灵敏度为83％（64％-93％），特异性为98％（80％-100％），而在无ROSE时，特异性为65％（57％-73％）和94％（31％-100％） 。在ROSE阳性和ROSE阴性病例中，诊断所需的数字分别为1.2（1.1-2.3）和1.7（1.4-8.3）。在没有和有ROSE的10名患者中，正确诊断的病例数分别从6（1-7）增加到8（4-9）。结论本研究客观证实了rEUS-FNA在先前无诊断或不确定性结果的情况下对实体胰腺肿块的诊断价值。此外，