Accuracy of Endoscopic Ultrasound in the Diagnosis of Distal and Celiac Axis Lymph Node Metastasis in Esophageal Cancer: A Meta-Analysis and Systematic Review
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Background Published data on the accuracy of endoscopic ultrasound (EUS) for staging distant and celiac axis lymph node (CLN) metastasis in patients with esophageal cancer (ECA) has varied. Aim To evaluate the accuracy of EUS in diagnosing distal and CLN metastasis in ECA patients. Method Study selection: EUS studies confirmed by surgery were selected. Statistical method: Pooling was conducted by both fixed and random-effects models. Results Data were extracted from 25 studies (N = 2029) which met the inclusion criteria. In ECA patients, pooled sensitivity of EUS was 67.2% (95% CI: 62.6–71.6) in diagnosis of distal metastasis and 66.6% (95% CI: 61.9–71.1) in diagnosis of CLN metastasis. EUS had a pooled specificity of 97.9% (95% CI: 97.1–98.6) for distal metastasis and 98.1% (95% CI: 97.3–98.7) for CLN metastasis. Conclusions Although EUS has excellent specificity in accurately diagnosing distal and CLN metastasis in patients with ECA, the sensitivity is low.