The diagnostic yield of endoscopic ultrasound-guided fine-needle biopsy in autoimmune pancreatitis: a systematic review and meta-analysis
- Journal
- BMC gastroenterology (Q2)
- Published
- 25 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Huiling Yu, Jingwei Kou, Qijin He, Dongxuan Zhang, Yalan Chen, Jie Liang
- PMID
- 42522011
- DOI
- 10.1186/s12876-026-05164-y
Why clinicians should know about it
- Picked for Histology (top studies of the week, 2 August 2026).
- Picked for Pathology and Forensic Medicine (top studies of the week, 2 August 2026).
Abstract
BACKGROUND AND AIM: Autoimmune pancreatitis (AIP) is a rare chronic form of pancreatitis mediated by autoimmune mechanisms. Evidence regarding the diagnostic performance of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) in AIP remains limited. This study aimed to estimate the pooled diagnostic accuracy of EUS-FNB in patients with AIP. METHODS: PubMed, Embase, Cochrane Library, CNKI, and Wanfang Database were systematically searched to identify fully published studies evaluating EUS-FNB for tissue sampling in AIP. Pooled estimates were generated using a random-effects model. The assessed outcomes included diagnostic accuracy, sample adequacy, contribution to AIP diagnosis, and adverse events. RESULTS: Sixteen studies, including one randomized controlled trial and four prospective studies, comprising 732 patients, were included. The overall diagnostic accuracy was 79% (73%-83%). Diagnostic accuracy was higher for the Franseen needle (83%, 75%-90%) and Fork-tip needle (90%, 80%-99%) compared with the reverse/forward‑bevel (51%, 31%-71%), with a statistically significant difference (P < 0.001). The 22G needle also demonstrated superior diagnostic accuracy (85%, 79%-91%) compared with 19G/20G needles (70%, 42%-98%) (P < 0.001). The pooled sample adequacy rate was 97% (95%-98%). EUS-FNB contributed to the diagnosis in 69% (50%-88%) of cases where diagnosis could not be established using imaging, serology, or involvement of other organs. The overall adverse event rate was 4% (1%-8%). CONCLUSIONS: EUS-FNB demonstrates excellent histological tissue acquisition and moderate diagnostic accuracy in AIP, with a low rate of adverse events. The 22G Franseen or Fork-tip needles may be a reasonable option, though direct comparative evidence is lacking.
Abstract as published, via PubMed.
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