Background and Aims

Assessment of EUS-guided fine-needle tissue acquisition by macroscopic on-site evaluation (MOSE) is gathering attention. Studies report good diagnostic parameters with MOSE; however, the overall data are limited. We conducted this systematic review and meta-analysis to report on the pooled diagnostic assessment parameters of EUS-guided tissue acquisition by MOSE using fine-needle biopsy sampling (FNB).

Methods

Multiple databases were searched (from inception to December 2021), and studies that reported on the diagnostic assessment of EUS-guided tissue acquisition by MOSE were selected. Pooled diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values were calculated by standard meta-analysis methods following the random-effects model. Heterogeneity was assessed by I² statistics.

Results

Fourteen studies were included in the analysis, and 1508 lesions were biopsy sampled in 1489 patients undergoing EUS-guided tissue acquisition. MOSE definition included a visible core of tissue with opacity and “wormlike” features of adequate size and length (≥4 mm). The pooled accuracy of FNA and/or FNB specimens in yielding a pathologic diagnosis by MOSE was 91.3% (95% confidence interval [CI], 88.6-93.3; I² = 66%), pooled sensitivity was 91.5% (95% CI, 88.6-93.6; I² = 66%), pooled specificity was 98.9% (95% CI, 96.6-99.7; I² = 80%), pooled positive predictive value was 98.8% (95% CI, 97.4-99.5; I² = 33%), and pooled negative predictive value was 55.5% (95% CI, 46.9-63.9; I² = 95%). Subgroup analyses by newer-generation FNB needles demonstrated similar pooled rates, with minimal adverse events (2.5%; 95% CI, 1.5-3.9; I² = 21%).

Conclusions

Excellent pooled diagnostic accuracy parameters were demonstrated in EUS-guided tissue acquisition by FNB using the MOSE method.

中文翻译：

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通过宏观现场评估对 EUS 引导的细针活检取样的诊断准确性：系统回顾和荟萃分析

背景和目标

通过宏观现场评估 (MOSE) 评估 EUS 引导的细针组织采集正在引起人们的关注。研究报告了 MOSE 的良好诊断参数；但是，总体数据有限。我们进行了这项系统回顾和荟萃分析，以报告使用细针活检取样 (FNB) 的 MOSE 进行的 EUS 引导组织采集的合并诊断评估参数。

方法

搜索了多个数据库（从开始到 2021 年 12 月），并选择了报告了 MOSE 对 EUS 引导的组织采集进行诊断评估的研究。合并诊断的准确性、敏感性、特异性以及阳性和阴性预测值是根据随机效应模型通过标准荟萃分析方法计算的。通过I ²统计评估异质性。

结果

分析中纳入了 14 项研究，对 1489 名接受 EUS 引导组织采集的患者的 1508 个病灶进行了活检。MOSE 定义包括可见的不透明组织核心和具有足够大小和长度（≥4 毫米）的“蠕虫状”特征。FNA 和/或 FNB 标本通过 MOSE 进行病理诊断的合并准确性为 91.3%（95% 置信区间 [CI]，88.6-93.3；I ²  = 66%），合并灵敏度为 91.5%（95% CI， 88.6-93.6；I ²  = 66%），合并特异性为 98.9%（95% CI，96.6-99.7；I ²  = 80%），合并阳性预测值为 98.8%（95% CI，97.4-99.5；I ²  = 33%），合并的阴性预测值为 55.5%（95% CI，46.9-63.9；我²  = 95%)。新一代 FNB 针的亚组分析显示相似的合并发生率，不良事件最少（2.5%；95% CI，1.5-3.9；I ²  = 21%）。

结论

在 EUS 引导的组织采集中，FNB 使用 MOSE 方法证明了出色的合并诊断准确性参数。