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

Table 1 General characteristics of included studies

Ref.	Year	Country	Study design	No. of patients	Cytology diagnostic category	Reference standard	LBC type
Chun et al[9]	2019	South Korea	Prospective	338	I/B/A/S/M	Combined	SurePath
Zhou et al[7]	2019	China	Retrospective	514	I/A/S/M/B/N	Combined	SurePath
Yeon et al[10]	2018	South Korea	Prospective	48	I/B/A/S/M	Combined	CellprepPlus
Lee et al[12]	2011	South Korea	Prospective	58	I/B/S/M	Combined	ThinPrep
LeBlanc et al[13]	2010	America	Prospective	50	I/B/A/S/M	Histology	ThinPrep
Qin et al[3]	2014	China	Prospective	72	B/M	Combined	ThinPrep
Hashimoto et al[11]	2017	Japan	Prospective	265	M/S/B	Combined	SurePath
Itonaga et al[8]	2019	Japan	Retrospective	311	B/M	Combined	ThinPrep

I: Inadequate; B: Benign; A: Atypical; S: Suspicious; M: Malignant; N: Neoplastic; LBC: Liquid-based cytology.

Table 2 Summary of results of liquid-based cytology, smear cytology, and the combination test in included studies

Diagnosismethod	Year	TP	FP	FN	TN	Study type1	Subject2	Sample3	Nature4	LBC type5	Pooled sensitivity	Pooled specificity	AUC
LBC											0.76 (0.72-0.79)	1.00 (0.98-1.00)	0.9176
Chun et al[9]	2019	142	0	22	5	0	1	0	0	1
Zhou et al[7]	2019	277	19	108	110	1	0	0	1	1
Yeon et al[10]	2018	17	0	11	20	0	0	0	0	0
Lee et al[12]	2011	33	0	11	14	0	0	0	1	0
LeBlanc et al[13]	2010	29	0	18	3	0	0	0	1	0
Qin et al[3]	2014	44	0	16	12	0	0	0	1	0
Hashimoto et al[11]	2017	52	0	6	5	0	1	0	0	1
SC											0.68 (0.64-0.71)	0.99 (0.96-1.00)	0.9714
Chun et al[9]	2019	129	0	35	5	0	1	0	0	1
Zhou et al[7]	2019	212	1	173	88	1	0	0	1	1
Yeon et al[10]	2018	24	0	4	20	0	0	0	0	0
Lee et al[12]	2011	41	0	3	14	0	0	0	1	0
LeBlanc et al[13]	2010	46	0	1	3	0	0	0	1	0
Qin et al[3]	2014	42	0	18	12	0	0	0	1	0
Hashimoto et al[11]	2017	32	0	18	13	0	1	0	0	1
LBC + SC											0.87 (0.84-0.90)	0.99 (0.96-1.00)	0.9894
Zhou et al[7]	2019	84	0	6	12	1	0	0	1	1
Yeon et al[10]	2018	84	0	6	12	0	0	0	0	1
Lee et al[12]	2011	84	0	6	12	0	0	0	1	0
Itonaga et al[8]	2019	84	0	6	12	1	0	1	0	0

¹0 = Prospective; 1 = Retrospective.

²0 = population received both liquid-based cytology (LBC) and smear cytology (SC) test; 1 = paired population received LBC and SC test respectively.

³0 = independent-samples; 1 = split-samples.

⁴0 = solid pancreatic lesion; 1 = no classification of the pancreatic lesions.

⁵0 = precipitation methods (ThinPrep, CellprepPlus); 1 = filtration methods (SurePath). TP: True positive; FP: False positive; FN: False negative; TN: True negative; LBC: Liquid-based cytology; SC: Smear cytology.

Table 3 Difference in sample inadequacy between liquid-based cytology and smear cytology

Ref.	Year	Country	No. of patients	Inadequacy, n (%)		LBC type
				LBC	SC
LeBlanc et al[13]	2010	America	50	50 (12.00)	50 (0.00)	ThinPrep
Lee et al[12]	2011	Korea	58	58 (34.48)	58 (13.79)	ThinPrep
Yeon et al[10]	2018	Korea	48	48 (41.67)	48 (12.50)	CellprepPlus
Chun et al[9]	2019	China	338	169 (1.78)	169 (5.32)	SurePath
Zhou et al[7]	2019	China	514	514 (2.33)	514 (4.28)	SurePath

LBC: Liquid-based cytology; SC: Smear cytology.

Table 4 Influence of each study on outcome of meta-analysis

Ref.	LBC			SC			LBC + SC
	Sensitivity	I2	AUC	Sensitivity	I2	AUC	Sensitivity	I2	AUC
Lee et al[12]	0.76 (0.72-0.79)	83.3	0.92	0.66 (0.63-0.69)	92.8	0.96	0.86 (0.83-0.89)	69.1	0.98
Yeon et al[10]	0.76 (0.73-0.79)	81.4	0.91	0.67 (0.63-0.70)	93.9	0.97	0.87 (0.83-0.90)	85.0	0.99
Hashimoto et al[11]	0.74 (0.71-0.78)	77.3	0.88	0.68 (0.64-0.71)	94.2	0.97	-	-	-
Qin et al[3]	0.76 (0.72-0.79)	83.2	0.92	0.67 (0.64-0.71)	94.2	0.97	-	-	-
Zhou et al[7]	0.79 (0.75-0.83)	79.7	0.94	0.70 (0.66-0.74)	84	0.97	0.94 (0.89-0.97)	15.6	0.99
LeBlanc et al[13]	0.76 (0.73-0.79)	80.2	0.94	0.66 (0.62-0.69)	91.2	0.97	-	-	-
Chun et al[9]	0.73 (0.69-0.76)	66.6	0.90	0.65 (0.61-0.68)	93.3	0.98	-	-	-
Itonaga et al[8]	-	-	-	-	-	-	0.86 (0.82-0.89)	77.6	0.99

LBC: Liquid-based cytology; SC: Smear cytology.