TY - JOUR
T1 - Diagnostic yield of EUS-FNA-based cytology distinguishing malignant and benign IPMNs
T2 - A systematic review and meta-analysis
AU - Suzuki, Rei
AU - Thosani, Nirav
AU - Annangi, Srinadh
AU - Guha, Sushovan
AU - Bhutani, Manoop S.
N1 - Publisher Copyright:
© 2014, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Objectives Differential diagnosis of malignant and benign intraductal papillary mucinous neoplasms (IPMNs) is essential to determine the optimal treatment. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently used to diagnose pancreatic cystic lesions worldwide, but few studies have focused on the diagnostic yield to distinguish malignant and benign IPMNs. Therefore, we aim to systematically review the diagnostic yield of EUS-FNA-based cytology to distinguish malignant and benign IPMNs.Methods Relevant studies with a reference standard of definitive surgical histology which published between 2002 and 2012 were identified via MEDLINE and SCOPUS. Malignant IPMNs included invasive adenocarcinoma, carcinoma in situ, and high-grade dysplasia.Results Four studies with 96 patients were included in this meta-analysis. For diagnostic yield of EUS-FNA-based cytology distinguishing malignant and benign IPMNs, the pooled sensitivity and specificity were 64.8% (95% CI, 0.44-0.82) and 90.6% (95% CI, 0.81-0.96), respectively. Similarly, the positive likelihood ratio and negative likelihood ratio were 6.35 (95% CI, 2.95-13.68) and 0.43 (95% CI, 0.14-1.34), respectively.Malignant IPMNs were observed in 20.8% (20/96) of patients in EUS-FNA studies. Conclusions EUS-FNA-based cytology has good specificity but poor sensitivity in differentiating benign from malignant IPMNs. Newer techniques or markers are needed to improve diagnostic yield.
AB - Objectives Differential diagnosis of malignant and benign intraductal papillary mucinous neoplasms (IPMNs) is essential to determine the optimal treatment. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is currently used to diagnose pancreatic cystic lesions worldwide, but few studies have focused on the diagnostic yield to distinguish malignant and benign IPMNs. Therefore, we aim to systematically review the diagnostic yield of EUS-FNA-based cytology to distinguish malignant and benign IPMNs.Methods Relevant studies with a reference standard of definitive surgical histology which published between 2002 and 2012 were identified via MEDLINE and SCOPUS. Malignant IPMNs included invasive adenocarcinoma, carcinoma in situ, and high-grade dysplasia.Results Four studies with 96 patients were included in this meta-analysis. For diagnostic yield of EUS-FNA-based cytology distinguishing malignant and benign IPMNs, the pooled sensitivity and specificity were 64.8% (95% CI, 0.44-0.82) and 90.6% (95% CI, 0.81-0.96), respectively. Similarly, the positive likelihood ratio and negative likelihood ratio were 6.35 (95% CI, 2.95-13.68) and 0.43 (95% CI, 0.14-1.34), respectively.Malignant IPMNs were observed in 20.8% (20/96) of patients in EUS-FNA studies. Conclusions EUS-FNA-based cytology has good specificity but poor sensitivity in differentiating benign from malignant IPMNs. Newer techniques or markers are needed to improve diagnostic yield.
KW - Cytology
KW - Endoscopic ultrasound-guided fine-needle
KW - Intraductal papillary mucinous neoplasm
KW - Malignancy
KW - Meta-analysis
KW - Pancreatic cystic lesion
KW - aspiration
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UR - http://www.scopus.com/inward/citedby.url?scp=84908256403&partnerID=8YFLogxK
U2 - 10.1016/j.pan.2014.07.006
DO - 10.1016/j.pan.2014.07.006
M3 - Article
C2 - 25278308
AN - SCOPUS:84908256403
SN - 1424-3903
VL - 14
SP - 380
EP - 384
JO - Pancreatology
JF - Pancreatology
IS - 5
ER -