Table 2.
Outcomes of meta-analyses on endoscopic ultrasound in esophageal carcinoma
| Ref. | Sensitivity (95%CI) | Specificity (95%CI) | Heterogeneity | Conclusion/interpretation |
| Puli et al[52], 2008 | Celiac N = 66% (62-71); M = 67% (63-72) | Celiac N = 98% (97-99); M = 98% (97-99) | Insignificant: P > 0.10 for all estimates | EUS has low sensitivity and utility for staging metastases to celiac lymph nodes and distant sites. |
| van Vliet et al[29], 2008 | N staging: EUS = 80% (75-84); CT = 50% (41-60); PET 57% (43-70) | N staging: EUS = 70% (65-75); CT = 83% (77-89); PET = 85% (76-95) | NR | EUS, CT, and PET have distinctive roles in staging. For distant metastases, PET probably has higher sensitivity than CT. No evidence of publication bias in CT vs EUS studies; other analyses too small to test. |
| Puli et al[32], 2008 | T1 = 82% (78-85); T4 = 92% (89-95); w/o FNA N = 85% (83-86); w/ FNA N = 97% (92-99) | T1 = 99.4% (99-100); T4 = 97% (97-98); w/o FNA N = 85% (83-86); w/ FNA N = 96% (91-98) | Insignificant: P > 0.10 for all estimates | EUS has excellent accuracy, with better performance in T4 over T1 disease (AUC 0.94-0.98). N staging is improved with FNA use (AUC 0.99 vs 0.89). |
| Thosani et al[30], 2012 | T1a = 85% (82-88); T1b = 86% (82-89) | T1a = 87% (84-90); T1b = 86% (83-89) | Significant; P < 0.05 by χ2 | EUS has good accuracy for T1a and T1b lesions; AUC ≥ 0.93. Technical factors can affect the diagnostic accuracy of EUS. |
| Sun et al[76], 2015 | T1 = 23% (16-32); T2 = 29% (19-41); T3 = 81% (72-88); T4 = 43% (31-56); N = 69% (58-79) | T1 = 95% (93-97); T2 = 84% (77-88); T3 = 42% (33-52); T4 = 96% (94-97) N = 52% (42-62) | Significant; I2 = 0%-75% depending on stage (table presented in article) | EUS has modest accuracy after neoadjuvant therapy; AUC for T staging ranges from 0.64 to 0.84, while AUC for N-staging was 0.64. |
| Qumseya et al[36], 2015 | ≥ T1sm = 56% (47-65) | >/-T1sm = 89% (85-92) | Significant; I2 = 82%; Q = 56, P < 0.0001 | Advanced disease detected in 14% (95%CI: 8%-22%; P < 0.0001). The NNT (performing EUS) to identify 1 case of advanced disease was 7 (95%CI: 5-13). EUS significantly changes therapeutic approach. |
NR: Not reported; EUS: Endoscopic ultrasonography; CT: Computed tomography; PET: Positron emission tomography; AUC: Area under the curve.