Abstract
The present study aimed to compare the diagnostic accuracy between conventional smear (CS) and liquid-based preparation (LBP) in endoscopic ultrasonography-fine needle aspiration cytology (EUS-FNAC) of pancreatic lesions. Using 31 eligible studies, the diagnostic accuracy of cytologic examination in CS and LBP was evaluated through a conventional meta-analysis and diagnostic test accuracy review. Overall concordance rates were 82.8% (95% confidence interval [CI], 79.8–85.5%) and 94.0% (95% CI, 84.4–97.8%) in CS and LBP, respectively. CS with rapid on-site evaluation (ROSE) showed a higher concordance rate than CS without ROSE. In CS, the pooled sensitivity and specificity were 89.8% (95% CI, 85.2–93.1%) and 95.0% (95% CI, 90.0–97.6%), respectively. The diagnostic odds ratio (OR) and area under curve (AUC) of the summary receiver operating characteristic (SROC) curve were 90.32 (95% CI, 43.85–147.11) and 0.945, respectively. In LBP, the pooled sensitivity and specificity were 80.9% (95% CI, 69.7–88.7%) and 99.9% (95% CI, 1.5–100.0%), respectively. The diagnostic OR and AUC of the SROC curve were 57.21 (95% CI, 23.61–138.64) and 0.939, respectively. Higher concordance rates were found in CS with ROSE and LBP in EUS-FNAC of pancreatic lesions. Regardless of the cytologic preparation method, EUS-FNAC is a useful and accurate diagnostic tool for pancreatic lesions.
Highlights
Fine needle aspiration (FNA) using endoscopic ultrasonography (EUS) was introduced in the1990s and has become a mainstay in recent years [1,2]
Conclusive information is not of pancreatic lesions with available owing to heterogeneous results of previous studies [25,26,29,44]
(95% CI, information is not available owing to heterogeneous results of previous studies
Summary
Fine needle aspiration (FNA) using endoscopic ultrasonography (EUS) was introduced in the. 1990s and has become a mainstay in recent years [1,2]. Pancreatic lesions include solid masses and cystic lesions. Sampling from cystic lesions may not be as effective as sampling from solid lesions. Sampling from pancreatic lesions has some limitations due to their anatomical location. To improve the diagnostic yield of pancreatic lesions, various protocol variations on EUS-FNA equipment and techniques have been studied and applied [1,2]. Due to advances in EUS techniques and the development of various tissue acquisition instruments, the diagnostic accuracy using EUS-FNA has been substantial. Various cytologic preparation methods have been developed and applied
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