Comparison of smear cytology and liquid-based cytology in EUS-guided FNA of pancreatic lesions: experience from a large tertiary center

摘要

abstract_textpBackground and Aims: Studies comparing the diagnostic efficacy of liquid-based cytology (LBC) and smear cytology (SC) of pancreatic tissue sampling obtained via EUS-guided FNA (EUS-FNA) are still insufficient, mainly because results were controversial. We compared the diagnostic efficiency of LBC and SC of EUS-FNA of pancreatic lesions in one of the largest tertiary hospitals in China./ppMethods: A retrospective database search (January 2015 to January 2019) was performed for patients who underwent EUS-FNA with both LBC and SC. Demographic, cytologic, and endosonographic data were collected from 819 patients; 514 cases met the inclusion criteria. Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were compared. Rapid on-site evaluation was not available in all cases./ppResults: Three hundred eighty-five cases (74.90) had confirmed malignancy, and 40 cases (7.78) confirmed benign neoplasm. Adequate tissue sampling rates showed no significant difference between the 2 groups. The sensitivity, accuracy, and negative predictive value (NPV) of LBC were higher than those of SC with statistical significance (71.4 vs 55.1, 76.1 vs 61.6, and 40.6 vs 27.7, respectively). The sensitivity, accuracy, and NPV of combined SC and LBC were higher than those of LBC alone with statistical significance (83.9 vs 71.4, 86.5 vs 76.1, and 56.8 vs 40.6, respectively). Multivariate analysis revealed that pancreatic neck/body/tail lesions (P=.003), solid lesions (P.001), 22-gauge needle size (P.001), and number of needle passage 3 (P = .041) were associated with higher diagnostic sensitivity in all participants using LBC, whereas number of needle passage 3 (P = .017) was associated with higher diagnostic sensitivity using SC./ppConclusions: LBC was more accurate and sensitive than SC in EUS-FNA of pancreatic lesions with higher NPV when rapid on-site evaluation is unavailable. Pancreatic neck/body/tail lesions, solid lesions, 22-gauge needle, and more than 3 passes were associated with higher sensitivity when using LBC. Performing more than 3 passes is associated with higher sensitivity when using SC./p/abstract_text