The Role of Fine Needle Aspiration Cytology in the Diagnosis of Gallbladder Cancer: A Systematic Review.

Georgios D Koimtzis,Leandros Stefanopoulos,Eliot Carrington-Windo,Christoforos S Kosmidis,Christopher G Chalklin,Mark Ramsden

doi:10.3390/diagnostics11081427

Abstract

Gallbladder cancer is the most common malignancy of the biliary tract. When diagnosed in an advanced stage it has a very poor prognosis. Therefore, early diagnosis and thorough assessment of a suspicious gallbladder polyp is essential to improve survival rate. The aim of this systematic review is to assess the role of fine needle aspiration cytology (FNAC) in the management of gallbladder cancer. For that purpose, a systematic review was carried out in the MEDLINE, EMBASE, Cochrane, Scopus and Google Scholar databases between 1 July 2004 and 22 April 2021. Six studies with 283 patients in total were included. Pooled sensitivity and specificity of FNAC were 0.85 and 0.94, respectively, while the area under the calculated summary receiver operating characteristic (SROC curve (AUC) was 0.98. No complications were reported. Based on the high diagnostic performance of FNAC in the assessment of gallbladder masses, we suggest that every suspicious mass should be evaluated further with FNAC to facilitate the most appropriate management.

Highlights

Biliary tract cancer (BTC) is a rare type of malignancy that makes up of less than 1% of human malignancies and 10–15% of all primary liver cancers [1]
The prognosis of gallbladder cancer is inferior to all other types of cholangiocarcinoma if it is not diagnosed at an early stage [1]
The pooled sensitivity of fine needle aspiration cytology (FNAC) was 0.85 (0.79–0.95, 95% confidence intervals (CIs)), with a large hetero neity among studies (Q = 28.62, I2 = 82.53 and p = 0.00) and the pooled specificity was FFiigguurree22..FFuunnnneellpp(l0loo.8tt7ww–i0itth.h98pp,sse9eu5ud%dooC995I5)%%wcciootnhnfifaiddeleonnwcceehiinnettteeerrrvvoaagllses,n,ueusistiinynggadmdaaottanagffrrotohmmemtthhee(Qssiixx=sst8tu.u8dd4iie,esIs,2,w=wi4itth3h.42, p = 0 lloogg--ddiiaaggnostic-odd(Fsi-grautrioes3d).isTphleaydeedsiignntehde ShhRoorOizConctuarlvaaexxiysi,eiilnndddeidiccaaattninAg UtthhCaattottfhhe0er.r9ee8ww(a0as.s9p7pr–ro0ob.b9aa9bb,lly9y5nn%ooCI), indi ppuubblliiccaattiioonnbbiiaassiinnintthgheeaiinnvccelluruyddehedidgsshttuudddiiaieegss.n. ostic accuracy of the FNAC (Figure 4)

Summary

Introduction

Biliary tract cancer (BTC) is a rare type of malignancy that makes up of less than 1% of human malignancies and 10–15% of all primary liver cancers [1]. Most commonly, it presents in the seventh decade of life with a small predominance in males [1]. The prognosis of gallbladder cancer is inferior to all other types of cholangiocarcinoma if it is not diagnosed at an early stage [1] These figures demonstrate the importance of exploring all possible avenues and of applying advanced diagnostic modalities with high accuracy to achieve early diagnosis of gallbladder cancer to ensure maximum survival

Methods

Results

Conclusion