Among All Other Biopsy for Suspected Pancreatic Cancer, How Efficient Is EUS-FNA and EUS-FNB. A Meta-Analysis

Background: EUS guided tissue acquisition is the gold standard technique for sampling pancreatic masses. Even though EUS guided fine needle aspiration and fine needle biopsy are still under dispute. Method: A computerized bibliographic search was conducted on main medical databases updated from 2017 to 2021 for including relevant RCTs in the Meta-analysis. The outcome measurements were diagnostic accuracy, specimen adequacy, adverse events, technical success (OR and 95%CI) and number of needle passes (MD and 95%CI). Result: A total of 1167 cases were included in the study from 11 RCTs. Diagnostic accuracy (OR: 0.43, 95%CI: 0.30-0.61) and specimen adequacy (OR: 0.50, 95%CI: 0.33-0.76) is higher in FNB group compared to FNA group. Technical success and adverse events shows no significant difference between two groups. Number of needle passes to acquire adequate tissue sample is comparatively less in FNB group than in FNA group. Conclusion: FNB is ideal choice over FNA for suspected pancreatic cancer masses. Abbreviation: EUS-FNA = Endoscopic ultrasound guided fine needle aspiration, EUS-FNB = Endoscopic ultrasound guided fine needle biopsy, RCTs = Randomized control trials, OR = Odds ratio, CI = Confidence interval, MD = Mean difference