Methods improving endoscopic retrograde cholangiopancreatography brush cytology in malignant biliary strictures

Table 1 Diagnostic methods of malignant biliary strictures: Sensitivity and specificity

Diagnostic method	Study design	Number of patients	Sensitivity (%)	Specificity (%)	Ref.
Brushing cytology	Review	1556	41.6 ± 3.2		Burnett et al[24]
	Prospective	109	40	100	Boldorini et al[47]
	Retrospective	74	67	98	Dudley et al[62]
	Retrospective	1017	65	78	Khan et al[48]
	Review		23-56	95	Singh et al[6]
	Prospective	102	36	85	Zoundjiekpon et al[50]
	Prospective	101	26-41	100	Kushnir et al[40]
FISH	Prospective	109	70	100	Boldorini et al[47]
	Retrospective	74	55	94	Dudley et al[62]
	Retrospective	1017	72	67	Khan et al[48]
	Prospective	102	20.0-42.9	82	Zoundjiekpon et al[50]
	Prospective	101	39	100	Kushnir et al[40]
	Review + meta-analysis	2516	57.6	87.8	Aggarwal et al[54]
NGS (MP)	Retrospective	74	74	98	Dudley et al[62]
	Prospective	101	50	97	Kushnir et al[40]
Brushing cytology + FISH	Retrospective	74	76	92	Dudley et al[62]
	Retrospective	1017	85	42	Khan et al[48]
	Prospective	101	50-60	95	Kushnir et al[40]
	Prospective	102	50	74	Zoundjiekpon et al[50]
Brushing cytology + NGS (MP)	Retrospective	74	85	96	Dudley et al[62]
	Prospective	101	56	95	Kushnir et al[40]
Brushing cytology + NGS (MP) + FISH	Retrospective	74	85	90	Dudley et al[62]
	Prospective	101	66-69	95	Kushnir et al[40]
Brushing cytology + fluoroscopic biopsy	Review		60-70	95	Singh et al[6]
Brushing cytology + bile fluid	Prospective	111	84	85	Roth et al[37]
Brushing cytology + miRNA	Prospective	57	54-85	95	Le et al[71]
Brushing cytology + miR-196a	Prospective	57	92.9	100	Le et al[71]
Brushing cytology + 2 positive of miR16, miR196a, miR221	Prospective	57	88.5	88.9	Le et al[71]

FISH: Fluoroscope in situ hybridization; MP: Molecular profiling; NGS: Next generation sequencing; miRNA: MicroRNA.