Efficacy for diagnoses of scirrhous gastric cancer and safety of endoscopic ultrasound‐guided fine‐needle aspiration: A systematic review and meta‐analysis

Scirrhous gastric cancer (SGC) is diagnosed using endoscopy and/or biopsy; however, SGC diagnosis remains challenging owing to its special growth form and morphologic features. Hence, endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA), which is minimally invasive and has a high proportion of diagnostic tissue, may be an alternative investigative modality for patients with suspected SGC. This systematic review and meta‐analysis aimed to identify and evaluate the evidence for the efficacy and safety of EUS‐FNA in patients with suspected SGC. We conducted a systematic review using the PubMed (MEDLINE) and Ichushi‐Web (NPO Japan Medical Abstracts Society) databases and included all entries in which SGC was evaluated using EUS‐FNA in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement from the databases′ inception to October 10, 2022. The primary outcome was the proportion of SGC diagnosed using EUS‐FNA. In addition, we analyzed the proportion of adverse events associated with EUS‐FNA. The electronic search identified 1890 studies; overall, four studies met the selection criteria and reported data on EUS‐FNA performed on 114 patients with suspected SGC. The overall diagnostic yield of EUS‐FNA for SGC was 82.6% (95% confidence interval, 74.6–90.6%) and the statistical heterogeneity was 0% (I (2) = 0%), indicating a low heterogeneity. Furthermore, the EUS‐FNA diagnostic proportion for SGC lymph node metastasis was 75–100%, indicating a high diagnostic performance. The adverse event rate of EUS‐FNA was 0%. EUS‐FNA may be an alternative investigation mode for SGC patients with negative esophagogastroduodenoscopy‐biopsy results.