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

Autor:	Chandan S; Division of Gastroenterology and Hepatology, CHI Creighton University Medical Center, Omaha, Nebraska, USA., Mohan BP; Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA., Khan SR; Section of Gastroenterology, Rush University Medical Center, Chicago, Illinois, USA., Ofosu A; Division of Gastroenterology & Hepatology, Stanford University, Stanford, California, United States., Dhaliwal AS; Division of Digestive Diseases & Nutrition, University of South Florida, Tampa, Florida, USA., Shah AR; Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Bhogal N; Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Mashiana HS; Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Mashiana SS; Pathology & Microbiology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Kassab LL; Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA., Ponnada S; Internal Medicine, Carilion Roanoke Memorial Hospital, Roanoke, Virginia, USA., Facciorusso A; Gastroenterology Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy., Bhat I; Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Singh S; Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, Nebraska, USA., Witt BL; Cytopathology Section, University of Utah School of Medicine, Salt Lake City, Utah, USA., Adler DG; Division of Gastroenterology and Hepatology, University of Utah School of Medicine, Salt Lake City, Utah, USA.
Jazyk:	angličtina
Zdroj:	Endoscopy international open [Endosc Int Open] 2020 Nov; Vol. 8 (11), pp. E1611-E1622. Date of Electronic Publication: 2020 Oct 22.
DOI:	10.1055/a-1240-0027
Abstrakt:	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. Competing Interests: Competing interests Dr. Adler is a consultant for Boston Scientific. (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze:	MEDLINE
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