Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology

Riet, Priscilla A. van; Quispel, Rutger; Cahen, Djuna L.; Snijders-Kruisbergen, Mieke C; Loenen, Petri van; Erler, Nicole S.; Poley, Jan–Werner; Driel, Lydi M.J.W. van; Mulder, Sanna A.; Veldt, Bart J.; Leeuwenburgh, Ivonne; Anten, Marie-Paule; Honkoop, Pieter; Thijssen, Ayla; Hol, Lieke; Hadithi, Mohammed; Fitzpatrick, Claire E.; Schot, Ingrid; Bergmann, J.F.; Bhalla, Abha; Bruno, Marco J.; Biermann, Katharina

doi:10.1055/a-1038-4103

Cited by 11 publications

(27 citation statements)

References 31 publications

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“…From an initial pool of 756 studies, 454 records were screened and 48 full-length articles were assessed. A total of nine studies (including 1308 patients) were included in the final analysis 18 32 33 34 35 36 37 38 39 . None of the included studies used ROSE.…”

Section: Resultsmentioning

confidence: 99%

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Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

et al. 2020

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Background and study aims Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) has limitations of inadequate sampling and false-negative results for malignancy. It has been performed using conventional smear (CS) cytology with rapid on-site evaluation (ROSE) with reasonable diagnostic accuracy. An alternative to ROSE is liquid-based cytology (LBC). Commonly used LBC techniques include precipitation-based (SurePath™) and filtration-based (ThinPrep®, CellPrep®). Data regarding the diagnostic efficacy of LBC compared with CS are limited. Methods Multiple databases were searched through March 2020 to identify studies reporting diagnostic yield of EUS-guided CS and LBC in pancreatic lesions. Pooled diagnostic odds and rates of performance for the cytologic diagnoses of benign, suspicious, and malignant lesions were calculated. Diagnostic efficacy was evaluated by pooled rates of accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Results Nine studies with a total of 1308 patients were included in our final analysis. Pooled diagnostic odds of CS cytology were 1.69 (CI 1.02–2.79) and 0.39 (CI 0.19–0.8) for malignant lesions when compared to filtration-based and precipitation-based LBC techniques, respectively. For CS, precipitation-based and filtration-based LBC, pooled diagnostic accuracy was 79.7 %, 85.2 %, 77.3 %, sensitivity was 79.2 %, 83.6 %, 68.3 %, and specificity was 99.4 %, 99.5 %, 99.5 %, respectively. Conclusions The precipitation-based LBC technique (SurePath™) had superior diagnostic odds for malignant pancreatic lesions compared with CS cytology in the absence of ROSE. It showed superior accuracy and sensitivity, but comparable specificity and PPV. Diagnostic odds of CS cytology in the absence of ROSE were superior to the filtration-based LBC technique (ThinPrep®, Cellprep®) for diagnosing malignant pancreatic lesions.

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Section: Resultsmentioning

confidence: 99%

“…Six studies were prospective in design, 18 23 32 35 39 40 and the remaining were retrospective. The detailed study quality evaluation is presented in Supplementary Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

et al. 2020

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“…Priscilla A. van Riet [17] *In this literature, although the data showed that LBC had higher diagnostic performance than CS, the results were not statistically signi cant. † This study mentioned that the inadequacy sample rates of CS and TCT samples were similar.…”

Section: 9%mentioning

confidence: 94%

“…In LBC, the cytological features of malignancy are retained and enhanced in a smaller screening area, which enhances accuracy in detection of malignant cells. Moreover, samples prepared from LBC can be saved for later cytological analysis, immunocytochemistry, special staining, and molecular based tests [17,18]. However, due to changes in background and cytological characteristics, pathologists need to be familiar with the morphology of LBC to avoid misdiagnosis [18].…”

Section: Diagnostic Yield Of Us-fnamentioning

confidence: 99%

Thinprep® test versus conventional smear for the detection of pancreatic neoplasms after percutaneous ultrasound-guided fine-needle aspiration biopsy

Tan

Zhou

Gui

et al. 2020

Preprint

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Background Few studies have defined the diagnostic value of ThinPrep pap test (a liquid-based cytology) for pancreatic samples obtained by percutaneous fine-needle aspiration (FNA). This study aimed to compare the efficacy of ThinPrep cytologic test (TCT) in screening pancreatic neoplasms to the conventional smear (CS), especially in the absence of rapid on-site evaluation (ROSE). Methods The study evaluated 78 patients with suspected pancreatic tumors who underwent percutaneous ultrasound-guided fine-needle aspiration (US-FNA) combined with CS and TCT. Final disease diagnosis was based on biopsy, surgery, or clinical progress. Results The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of TCT were 95.8%, 100%, 96.1%, 100%, 62.5%, whereas the values for CS were 90.1%, 100%, 90.8%, 100%, 41.7%, respectively. The combination of CS and TCT recorded 98.6%, 100%, 98.7%, 100%, 83.3%, respectively, for the parameters evaluated. None of the participants recorded serious complications. Conclusions This study shows that TCT is a more reliable tool in the detection of pancreatic neoplasms, especially for percutaneous US-FNA samples. Whereas TCT may be used as an alternative to CS in the absence of ROSE, the use of both methods in the screening process yields better results.

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“…Several studies have evaluated the diagnostic efficacy of LBC and SC in pancreatic EUS-FNA cytology by comparing the key differences between the two cytological diagnostic techniques[ 3 , 7 - 14 ]. However, these studies have reported conflicting results that might be attributable to the diversity of the subject population, subtle differences in detailed procedures, and the infancy of application of this technology in this specialized field.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic value of liquid-based cytology and smear cytology in pancreatic endoscopic ultrasound-guided fine needle aspiration: A meta-analysis

Pan

Zhou

Zhao

et al. 2020

WJCC

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BACKGROUND Smear cytology (SC) using endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the established and traditional choice for diagnosing pancreatic lesions. Liquid-based cytology (LBC) is a novel alternative cytological method, however, the comparative diagnostic efficacy of LBC remains inconclusive. AIM To examine the diagnostic efficacy of LBC and SC for pancreatic specimens obtained through EUS-FNA via a systematic review and meta-analysis. METHODS A systematic literature search was performed using PubMed, EMBASE, the Cochrane Library, and Web of Science. The numbers of true positives, false positives, true negatives, and false negatives for each cytological test (LBC and CS) were extracted from the included studies. The pooled sensitivity and specificity and the area under the summary receiver operating characteristic curve (AUC) were calculated, and the AUC was compared by Tukey's multiple comparisons test. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies II tool. RESULTS A total of 1656 patients in eight studies were included. The pooled sensitivity and specificity and the AUC for LBC were 0.76 (95%CI: 0.72-0.79), 1.00 (95%CI: 0.98-1.00), and 0.9174, respectively, for diagnosing pancreatic lesions. The pooled estimates for SC were as follows: Sensitivity, 0.68 (95%CI: 0.64-0.71); specificity, 0.99 (95%CI: 0.96-100.00); and AUC, 0.9714. Similarly, the corresponding values for LBC combined with SC were 0.87 (95%CI: 0.84-0.90), 0.99 (95%CI: 0.96-1.00), and 0.9894. Tukey’s multiple comparisons test was used to compare the sensitivities and AUCs of the three diagnostic methods; statistically significant differences were found between the three methods, and LBC combined with SC was superior to both LBC ( P < 0.05) and SC ( P < 0.05). The pooled sensitivity and AUC did not change significantly in the sensitivity analysis. CONCLUSION LBC may be sensitive than SC in the cytological diagnosis of pancreatic lesions, however, the superior diagnostic performance of their combination emphasizes their integrated usage in the clinical evaluation of pancreatic lesions.

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Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology

Cited by 11 publications

References 31 publications

Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

Comparison of EUS-guided conventional smear and liquid-based cytology in pancreatic lesions: A systematic review and meta-analysis

Thinprep® test versus conventional smear for the detection of pancreatic neoplasms after percutaneous ultrasound-guided fine-needle aspiration biopsy

Diagnostic value of liquid-based cytology and smear cytology in pancreatic endoscopic ultrasound-guided fine needle aspiration: A meta-analysis

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