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Comparison of endoscopic ultrasonography and magnifying endoscopy for assessment of the invasion depth of shallow gastrointestinal neoplasms: a systematic review and meta-analysis

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Abstract

Objectives

To conduct a meta-analysis to provide accurate evidence regarding the preferred diagnostic method, magnifying endoscopy (ME) or endoscopic ultrasonography (EUS), for assessment of the depth of invasion of the gastrointestinal neoplasms.

Methods

PubMed, EMBASE, Ovid Medline, and the Cochrane Library databases were searched for studies published between January 1946 and October 2016, regarding the use of EUS and ME to assess the invasion depth of gastrointestinal cancers. The quality of diagnostic studies was evaluated using the QUADAS2 instrument. The Meta-DiSc software (version 1.4) was used for meta-analysis of the pooled data regarding the diagnostic accuracy of EUS and ME of the invasion depth of gastrointestinal neoplasms.

Results

Our meta-analysis included the data of 754 patients with gastrointestinal cancers contributed by seven prospective studies. All studies were of high quality (QUADAS2). The receiver operating characteristic (ROC) planes were not observed in shoulder and arm forms for either EUS or ME, with Spearman’s correlation coefficients of −0.821 and 0.234 for EUS and ME, respectively. The p values of the diagnostic odds ratio for EUS and ME were 0.0038 and 0.0131, respectively. The sensitivity and specificity of EUS for the diagnosis of the depth of invasion of gastrointestinal cancers were 0.75 (95% CI 0.69–0.81) and 0.84 (95% CI 0.79–0.88), respectively. In comparison, the sensitivity and specificity for ME were 0.74 (95% CI 0.67–0.69) and 0.85 (95% CI 0.80–0.89), respectively. The values of area under the summary ROC (SROC) curves for EUS and ME were 0.8499 and 0.8757, respectively, with a non-significant Z value between EUS and MR (0.296 < 1.96).

Conclusions

Both EUS and ME provide a comparable performance for judging the depth of invasion of gastrointestinal neoplasms. However, there is heterogeneity between studies contributed by non-threshold effects.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (Grant No. 81671798). Corresponding author Xiao Li had proposed the idea. First author Zhang Tao had made the study design, literature searching and data analysis. Co-author Chen Yan had made the literature searching, data extract. Co-author He Zhao had contributed to picture modification. Co-author Jiawei Tsauo had contributed to manuscript structure modification. Co-authors Xiaowu Zhang, Bing Qiu, Yanqing Zhao had contributed to data extract, and data analysis.

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  1. Zhang Tao and Chen Yan have contributed equally to this work and are the co-first authors.

Authors and Affiliations

  1. Department of Interventional Therapy, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100021, China

    Zhang Tao, He Zhao, Xiaowu Zhang, Bing Qiu, Yanqing Zhao & Xiao Li

  2. Department of Gastroenterology, Jing Men No.2 People’s Hospital, Jingchu Center Hospital Affiliated to Institute of Technology, Jing Men City, 448000, Hubei, China

    Zhang Tao

  3. Department of Gastroenterology and Geriatrics, West China Hospital, Sichuan University, Chengdu, 637000, Sichuan, China

    Chen Yan

  4. Department of Radiology and Interventional Therapy, West China Hospital, Sichuan University, Chengdu, 637000, Sichuan, China

    Jiawei Tsauo

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  1. Zhang Tao
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Correspondence to Xiao Li.

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All authors Zhang Tao, Chen Yan, He Zhao, Jiawei Tsauo, Xiaowu Zhang, Bing Qiu, Yanqing Zhao, Xiao Li had no interest conflict in the article.

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Tao, Z., Yan, C., Zhao, H. et al. Comparison of endoscopic ultrasonography and magnifying endoscopy for assessment of the invasion depth of shallow gastrointestinal neoplasms: a systematic review and meta-analysis. Surg Endosc 31, 4923–4933 (2017). https://doi.org/10.1007/s00464-017-5596-8

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