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

doi:10.12998/wjcc.v9.i14.3308

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World Journal of Clinical Cases

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Meta-Analysis

World J Clin Cases. May 16, 2021; 9(14): 3308-3319
Published online May 16, 2021. doi: 10.12998/wjcc.v9.i14.3308

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

Xiao-Hui Zhang, Shi-Yang Ma, Na Liu, Zhong-Cao Wei, Xu Gao, Yu-Jie Hao, Yi-Xin Liu, Ya-Qin Cai, Jin-Hai Wang

Xiao-Hui Zhang, Shi-Yang Ma, Na Liu, Zhong-Cao Wei, Xu Gao, Yu-Jie Hao, Yi-Xin Liu, Ya-Qin Cai, Jin-Hai Wang, Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China

Author contributions: Zhang XH and Wang JH designed the research study; Zhang XH and Wei ZC screened the articles and extracted the data; Zhang XH, Liu YX, and Cai YQ compiled the tables and figures; Zhang XH, Gao X, and Hao YJ analyzed the data; Zhang XH wrote the manuscript; Ma SY and Liu N critically modified the content of the article; All authors have read and approve the final manuscript.

Conflict-of-interest statement: No potential conflicts of interest exist.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Jin-Hai Wang, MD, Doctor, Professor, Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, No. 157 West Fifth Road, Xi'an 710004, Shaanxi Province, China. jinhaiwang@hotmail.com

Received: November 12, 2020
Peer-review started: November 12, 2020
First decision: January 23, 2021
Revised: January 30, 2021
Accepted: March 10, 2021
Article in press: March 10, 2021
Published online: May 16, 2021
Processing time: 167 Days and 18.1 Hours

ARTICLE HIGHLIGHTS

Research background

Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) is a safe and accurate technique to confirm the diagnosis of pancreatic cancers. The best cytological method for EUS-FNA in pancreatic lesions is controversial.

Research motivation

Recently, numerous studies comparing the diagnostic efficacy of smear cytology (SC) and liquid-based cytology (LBC) for pancreatic lesions yielded mixed results.

Research objectives

To compare and identify the better cytology method for EUS-FNA in pancreatic lesions.

Research methods

A comprehensive search of PubMed, Embase, and Cochrane was undertaken through July 18, 2020.

Research results

Data on a total of 1121 comparisons from 10 studies met the inclusion criteria. Pooled rates of sensitivity for SC and LBC were 78% (67%-87%) vs 75% (67%-81%), respectively. In any case, both SC and LBC exhibited a high specificity close to 100%. Inadequate samples more often appeared in LBC compared with SC. However, the LBC samples exhibited a better visual field than SC. Very few post procedure complications were observed.

Research conclusions

For EUS-FNA in pancreatic lesions (particularly solid lesions), SC with Rapid On-Site Evaluation (ROSE) represents a superior diagnostic technique. If ROSE is unavailable, LBC may replace smears. The diagnostic accuracy of LBC depends on different LBC techniques.

Research perspectives

The need for more staff and material resources has limited the use of ROSE in some institutions. It makes sense to evaluate the diagnostic performance of different LBC methods for EUS-FNA in pancreatic lesions.