Meta-Analysis for Cyto-Pathological Outcomes in Endoscopic Ultrasonography-Guided Fine-Needle Aspiration With and Without the Stylet

• Published in: Digestive diseases and sciences 2016-08, Vol.61 (8), p.2175-2184
• Main Authors: Kim, Jae Hyun, Park, Se Woo, Kim, Mi Kang, Lee, Jin, Kae, Sea Hyub, Jang, Hyun Joo, Koh, Dong Hee, Choi, Min Ho
• Format: Article
• Language: English
• Subjects: Adrenal Gland Neoplasms - pathology; Analysis; Biochemistry; Endoscopic ultrasonography; Endoscopic Ultrasound-Guided Fine Needle Aspiration - instrumentation; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods; Gastroenterology; Gastrointestinal Neoplasms - pathology; Hepatology; Humans; Lymph Nodes - pathology; Mediastinal Neoplasms - pathology; Medicine; Medicine & Public Health; Needles; Odds Ratio; Oncology; Pancreatic Neoplasms - pathology; Pneumoviridae; Review; Transplant Surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-016-4130-5

Background Theoretically, use of the stylet during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) will prevent the tip of the needle from being blocked and the sample from being contaminated, improving the quality and diagnostic yield of specimens. Aim This meta-analysis aimed to evaluate any benefit from the use of a stylet during EUS-FNA. Methods MEDLINE, EMBASE, WEB of SCIENCE, and the Cochrane Central Register of Controlled Trials were searched for articles published through October 2015. A fixed-effects model was used to calculate the pooled effects when there is no heterogeneity and a random-effects model was used in situations with significant heterogeneity. Results Five prospective randomized controlled studies and two retrospective studies of a total of 5491 specimens (2504 specimens in the S+ group and 2987 specimens in the S− group) were included in this study. The pooled analysis demonstrated no significant differences in the adequate sample rate between the S+ group (2135/2504, 85.26 %) and S− group (2609/2987, 87.35 %) [odds ratio 0.94 (95 % confidence interval 0.79–1.11), p  = 0.45]. Furthermore, the rate of cellularity > 50 %, the contamination rate, and the blood contamination rate were not significantly superior in the S+ group when compared with the S− group. Conclusions Whether the use of a stylet improves the proportion of adequate specimens or quality of the specimen is questionable. Our results suggest that the use of a stylet dose not guarantee any advantage during EUS-guided tissue sampling.