BACKGROUND: Preoperative diagnosis of malignancy in pancreatic cystic lesions (PCLs) remains challenging. Most non-mucinous cystic lesions (NMCLs) are benign, but mucinous cystic lesions (MCLs) are more likely to be premalignant or malignant. AIM: The aim of this study was to assess the sensitivity, specificity, and positive and negative likelihood ratios (LRs) of EUS-FNA-based cytology in differentiating MCLs from non-mucinous PCLs. METHODS: We conducted a comprehensive search of MEDLINE, SCOPUS, Cochrane, and "CINAHL Plus" databases to identify studies, in which the results of EUS-FNA-based cytology of PCLs were compared with those of surgical biopsy or surgical excision histopathology. A DerSimonian-Laird random effect model was used to estimate the pooled sensitivity, specificity, and LRs, and a summary receiver-operating characteristic (SROC) curve was constructed. RESULTS: We included 376 patients from 11 distinct studies who underwent EUS-FNA-based cytology and also had histopathological diagnosis. The pooled sensitivity and specificity in diagnosing MCLs were 0.63 (95% CI, 0.56-0.70) and 0.88 (95% CI, 0.83-0.93), respectively. The positive and negative LRs in diagnosing MCLs were 4.46 (95% CI, 1.21-16.43) and 0.46 (95% CI, 0.25-0.86), respectively. The area under the curve (AUC) was 0.89. CONCLUSIONS: EUS-FNA-based cytology has overall low sensitivity but good specificity in differentiating MCLs from NMCLs. Further research is required to improve the overall sensitivity of EUS-FNA-based cytology to diagnose MCLs while evaluating PCL.
BACKGROUND: Preoperative diagnosis of malignancy in pancreatic cystic lesions (PCLs) remains challenging. Most non-mucinous cystic lesions (NMCLs) are benign, but mucinous cystic lesions (MCLs) are more likely to be premalignant or malignant. AIM: The aim of this study was to assess the sensitivity, specificity, and positive and negative likelihood ratios (LRs) of EUS-FNA-based cytology in differentiating MCLs from non-mucinous PCLs. METHODS: We conducted a comprehensive search of MEDLINE, SCOPUS, Cochrane, and "CINAHL Plus" databases to identify studies, in which the results of EUS-FNA-based cytology of PCLs were compared with those of surgical biopsy or surgical excision histopathology. A DerSimonian-Laird random effect model was used to estimate the pooled sensitivity, specificity, and LRs, and a summary receiver-operating characteristic (SROC) curve was constructed. RESULTS: We included 376 patients from 11 distinct studies who underwent EUS-FNA-based cytology and also had histopathological diagnosis. The pooled sensitivity and specificity in diagnosing MCLs were 0.63 (95% CI, 0.56-0.70) and 0.88 (95% CI, 0.83-0.93), respectively. The positive and negative LRs in diagnosing MCLs were 4.46 (95% CI, 1.21-16.43) and 0.46 (95% CI, 0.25-0.86), respectively. The area under the curve (AUC) was 0.89. CONCLUSIONS: EUS-FNA-based cytology has overall low sensitivity but good specificity in differentiating MCLs from NMCLs. Further research is required to improve the overall sensitivity of EUS-FNA-based cytology to diagnose MCLs while evaluating PCL.
Authors: Robert Sedlack; Aboud Affi; Enrique Vazquez-Sequeiros; Ian D Norton; Jonathan E Clain; Maurits J Wiersema Journal: Gastrointest Endosc Date: 2002-10 Impact factor: 9.427
Authors: D F Stroup; J A Berlin; S C Morton; I Olkin; G D Williamson; D Rennie; D Moher; B J Becker; T A Sipe; S B Thacker Journal: JAMA Date: 2000-04-19 Impact factor: 56.272
Authors: Lyndon V Hernandez; Girish Mishra; Christopher Forsmark; Peter V Draganov; John M Petersen; Steven N Hochwald; Stephen B Vogel; Manoop S Bhutani Journal: Pancreas Date: 2002-10 Impact factor: 3.327
Authors: M G Sarr; H A Carpenter; L P Prabhakar; T F Orchard; S Hughes; J A van Heerden; E P DiMagno Journal: Ann Surg Date: 2000-02 Impact factor: 12.969
Authors: Asif Khalid; Maliha Zahid; Sydney D Finkelstein; Julia K LeBlanc; Neeraj Kaushik; Nuzhat Ahmad; William R Brugge; Steven A Edmundowicz; Robert H Hawes; Kevin M McGrath Journal: Gastrointest Endosc Date: 2009-01-18 Impact factor: 9.427
Authors: Ji Kon Ryu; Hanno Matthaei; Marco Dal Molin; Seung-Mo Hong; Marcia I Canto; Richard D Schulick; Christopher Wolfgang; Michael G Goggins; Ralph H Hruban; Leslie Cope; Anirban Maitra Journal: Pancreatology Date: 2011-07-12 Impact factor: 3.996