Diagnostic value of endoscopic ultrasound for insulinoma localization: A systematic review and meta-analysis

BACKGROUND: Previous studies reported varies parameters of endoscopic ultrasound (EUS) for the localization of insulinomas, the purpose of this meta-analysis based on published studies to accuracy the diagnostic value of EUS. METHODS: PubMed, Embase, Web of science, Cochrane library and Wanfang digital database were searched to identify published studies up to April 2018, which diagnostic insulinoma by using EUS. Retrieved sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and receiver operating characteristic (ROC) curves data were summarized for meta-analysis. RESULTS: A total of 9 studies involved a total of 350 patients were included in final analysis. The summary sensitivity, specificity, PLR, and NLR were 0.81 (95%CI: 0.75–0.86), 0.90 (95%CI: 0.84–0.94), 7.90 (95%CI: 4.9–12.8), and 0.21 (95%CI: 0.16–0.29), respectively. Further, the pooled DOR was 37.00 (95%CI:19.55–70.04) and area under the ROC was 0.92 (95%CI: 0.90–0.84). CONCLUSION: The findings of this study demonstrate that EUS should be a routine diagnosis approach for the preoperative localization of insulinomas.