Performance of K-ras mutation analysis plus endoscopic ultrasound-guided fine-needle aspiration for differentiating diagnosis of pancreatic solid mass: a meta-analysis / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 3296-3301, 2014.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-240180
Responsible library:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Difficulties persist in differentiating pancreatic ductal adenocarcinomas (PDAC) from pancreatic inflammatory masses (PIM). Auxiliary diagnostic techniques which enhance the endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) diagnostic yield have been attempted, for example, K-ras mutation analysis. We aimed to evaluate the accuracy of K-ras mutation analysis combined with EUS-FNA for the differential diagnosis of PDAC and PIM by pooling data of existing trials.</p><p><b>METHODS</b>We systematically searched the Medline, PubMed, Web of Science, Embase, and Cochrane Central Trials databases for relevant published studies. Meta-analysis was performed. Pooling was conducted in fixed-effect model or random-effect model.</p><p><b>RESULTS</b>In total eight studies, with 696 cases of PDAC and 138 cases of PIM, met our inclusion criteria. The pooled sensitivity, specificity, positive likely ratio and negative likely ratio of K-ras mutation analysis combined with cytopathology for diagnosis of PDAC versus PIM were 90%, 95%, 13.45, and 0.13, respectively. Especially, among total 123 patients whose EUS-FNA results were inconclusive or negative, fifty-nine had K-ras mutations and were finally diagnosed with PDAC (48%, 59/123). Publication bias was not present.</p><p><b>CONCLUSIONS</b>Combining K-ras mutation analysis with routine cytology moderately improves the ability of EUS-FNA to differentially diagnose between PDAC and PIM, especially for patients with suspected PDAC yet inconclusive EUS-FNA findings, and may prove to be a valuable supplemental method to EUS-FNA.</p>
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Pancreatic Neoplasms
/
Genes, ras
/
Diagnosis
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Endoscopic Ultrasound-Guided Fine Needle Aspiration
/
Genetics
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Methods
/
Mutation
Type of study:
Diagnostic study
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Prognostic study
/
Systematic review
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Medical Journal
Year:
2014
Document type:
Article