{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T02:42:16Z","timestamp":1786761736758,"version":"build-2736575974"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,2,17]],"date-time":"2014-02-17T00:00:00Z","timestamp":1392595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Accurate preoperative staging of ampullary neoplasms is of paramount importance in predicting prognosis and determining the most appropriate therapeutic approach. The aim of the present review was to evaluate the accuracy of endoscopic ultrasound (<jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content>) in predicting depth of ampullary tumor invasion (<jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>\u2010stage) and regional lymph node status (<jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>\u2010stage) by carrying out a meta\u2010analysis of all relevant studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>, <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edline and <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>copus databases for all studies published between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 1980 and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2012. Only <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> studies involving \u226510 patients with ampullary neoplasms, confirmed by surgical histopathology, with data available for construction of a 2\u2009\u00d7\u20092 table were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Meta\u2010analysis of 14 studies involving 422 patients using the <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>antel\u2013<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>aenszel method was performed. Pooled sensitivity and specificity of <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> to diagnose <jats:styled-content style=\"fixed-case\">T1<\/jats:styled-content>\u2010stage tumor were 77% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 69\u201383) and 78% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 72\u201384), respectively. Pooled sensitivity for <jats:styled-content style=\"fixed-case\">T<\/jats:styled-content>4 tumors was 84% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 73\u201392) and specificity was 74% (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 63\u201383). Combined sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for diagnosing nodal status were 0.70 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.62\u20130.77), 0.74 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.67\u20130.0.80), 2.49 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.91\u20133.24), 0.46 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.36\u20130.59) and 6.53 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 3.81\u201311.19), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on our pooled estimates, <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> had a moderate strength of agreement with histopathology in preoperative staging of ampullary neoplasms in predicting tumor invasion and lymph node involvement. Additional refinement in <jats:styled-content style=\"fixed-case\">EUS<\/jats:styled-content> technologies and diagnostic criteria may be required to enhance staging accuracy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12234","type":"journal-article","created":{"date-parts":[[2014,2,18]],"date-time":"2014-02-18T02:42:38Z","timestamp":1392691358000},"page":"617-626","source":"Crossref","is-referenced-by-count":61,"title":["Staging accuracy of ampullary tumors by endoscopic ultrasound: <scp>M<\/scp>eta\u2010analysis and systematic review"],"prefix":"10.1111","volume":"26","author":[{"given":"Guru","family":"Trikudanathan","sequence":"first","affiliation":[{"name":"Division of Gastroenterology University of Minnesota  Minneapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basile","family":"Njei","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Connecticut  Farmington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajeev","family":"Attam","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Minnesota  Minneapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Arain","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Minnesota  Minneapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasma","family":"Shaukat","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology University of Minnesota  Minneapolis USA"},{"name":"Division of Gastroenterology Hepatology and Nutrition VA Medical Center  Minneapolis USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,2,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200012010-00014"},{"key":"e_1_2_8_3_1","first-page":"37","article-title":"Adenoma and carcinoma of the duodenum and papilla of Vater: A clinicopathologic study","volume":"87","author":"Seifert E","year":"1992","journal-title":"Am. 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