Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: A meta-analysis of randomized controlled trials

BACKGROUND: The comparison between endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) and EUS guided fine needle biopsy (FNB) in sampling pancreatic masses is still controversial. METHODS: A systematic search was conducted in PubMed and Web of Science to identify all relevant randomized controlled trials (RCTs). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated for dichotomous outcomes of interest (specimen adequacy, diagnostic accuracy, complications, and technical success), while mean difference (MD) and 95% CI were pooled for continuous variables (number of needle passes required for diagnosis). RESULTS: Eleven RCTs were identified with a total of 694 EUS-FNA cases and 688 EUS-FNB cases. Compared with EUS-FNA, EUS-FNB had a better specimen adequacy (OR: 1.83, 95% CI: 1.27–2.64), higher diagnostic accuracy (OR: 1.62, 95% CI: 1.17–2.26), and fewer number of needle passes (MD: 0.69, 95% CI: 1.18 to 0.20). No significant difference was found in complications (OR: 1.01, 95% CI: 0.27–3.78) and technical success (OR: 0.13, 95% CI: 0.02–1.07). CONCLUSION: EUS-FNB is superior to EUS-FNA in sampling pancreatic masses.