Diagnostic Performance Of Ultrasound-Guided Fine Needle Aspiration Biopsy And Core Needle Biopsy In Breast Nodules:A Meta-Analysis

Objective: Applying a meta-analysis to evaluate the diagnostic performance of ultrasound-guided fine needle aspiration biopsy and core needle biopsy in breast nodules.Methods: A comprehensive search of Pubmed,Embase,Cochrane Library,Wanfang,CNKI,and VIP databases was conducted to find literature on ultrasound-guided fine needle aspiration biopsy and core needle biopsy for diagnosis of breast nodules.The search period is the date of database construction until December 2017.The literature screening was performed with reference to the Cochrane Handbook standards for diagnostic tests,and the fourfold table was extracted.QUADAS-2(quality assessment of diagnostic accuracy studies-2)was used as a quality assessment tool,and the Review Manager 5.3 was applied to draw summary charts and regulations for the results of literature quality assessment.According to the results of the heterogeneity test,Meta-disc 1.4 is used to select the corresponding effect model whichshould be merged,and the pooled specificity,sensitivity,odds ratio,and its 95% confidence interval were calculated,at the meantime,the SROC(Summary Receiver Operating Characteristic)curve was drawn,and the area under the curve was calculated.Stata 14.0 software was applied to draw a funnel plot to detect publication bias.Results: A total of 9 papers were included,1005 nodules(624malignant nodules and 381 benign nodules).Both fine needle aspiration biopsy and core needle biopsy showed no significant heterogeneity.Using a random-effects model,meta-analysis showed that the combined specificity,sensitivity,positive likelihood ratio,negative likelihood ratio,and diagnostic odds ratio for the diagnosis of breast nodule by fine needle aspiration biopsy were 97%(95%CI: 0.95-0.99),82%(95%CI: 0.78-0.85),24.80(95%CI: 8.37-73.50),0.20(95%CI: 0.15-0.29),and 117.81(95%CI:45.40-305.75)respectively;meanwhile,the corresponding indicators by core needle biopsy were 99%(95%CI: 0.98-1.00),91%(95%CI: 0.88-0.93),32.69(95%CI: 15.40-69.40),0.11(95%CI: 0.08-0.14),and 471.47(95%CI:191.01-1163.73),respectively.The area under the SROC curve: fine needle aspiration biopsy 0.9220,core needle biopsy 0.9848.The funnel plot showed that ultrasound-guided fine needle aspiration biopsy and core needle biopsy are both has certain biased.Conclusions: Ultrasound-guided fine needle aspiration biopsy and core needle biopsy both have high diagnostic performance for breastnodules,and have clinical application prospects.In consideration of test efficiency,The diagnostic value of ultrasound-guided core needle biopsy is higher than ultrasound-guided fine needle aspiration biopsy,it is of great value in terms of accurate qualitative,preoperative chemotherapy,and guided surgery.