Ding Cong, Yang Jian-Feng, Wang Xia, Zhou Yi-Feng, Gu Ye, Liu Qiang, Shen Hong-Zhang, Zhang Xiao-Feng
Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou, Zhejiang, China.
Key Laboratory of Integrated Traditional Chinese and Western Medicine for Biliary and Pancreatic Diseases of Zhejiang Province, Hangzhou, Zhejiang, China.
PLoS One. 2025 Feb 20;20(2):e0314825. doi: 10.1371/journal.pone.0314825. eCollection 2025.
Preoperative diagnosis of malignancy in patients with pancreatic cystic lesions (PCLs) remains challenging. The aim of this study was to assess the sensitivity, specificity, and positive and negative likelihood ratios (LRs) of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA)-based cytology in differentiating malignant PCLs from benign PCLs.
A comprehensive search was performed in multiple databases in November 2023. Studies differentiating benign and malignant PCLs via EUS-FNA-based cytology, in which the results were compared with those of surgical excision histopathology, were included in this meta-analysis. Data from the selected studies were pooled to summarize the sensitivity, specificity, positive and negative LRs, diagnostic odds ratios and summary receiver operating characteristic (SROC) curves.
We included 755 patients from 15 distinct studies who underwent EUS-FNA-based cytology and had a histopathological diagnosis. The pooled sensitivity and specificity in diagnosing malignant PCLs were 0.62 (95% CI, 0.42-0.78) and 0.96 (95% CI, 0.91-0.98), respectively. The positive and negative LRs for diagnosing malignant PCLs were 16.3 (95% CI, 7.2-37.0) and 0.40 (95% CI, 0.25-0.64), respectively. The area under the curve (AUC) was 0.94 (95% CI, 0.91-0.95).
EUS-FNA-based cytology has overall high specificity, medium sensitivity and good diagnostic accuracy in differentiating malignant from benign PCLs. Further research is needed to improve the overall sensitivity of EUS-FNA-based cytology for the diagnosis of malignant PCLs.
胰腺囊性病变（PCL）患者的术前恶性肿瘤诊断仍然具有挑战性。本研究的目的是评估基于内镜超声引导下细针穿刺抽吸（EUS-FNA）的细胞学检查在鉴别恶性PCL与良性PCL方面的敏感性、特异性、阳性和阴性似然比（LR）。
2023年11月在多个数据库中进行了全面检索。本荟萃分析纳入了通过基于EUS-FNA的细胞学检查鉴别良性和恶性PCL的研究，其中将结果与手术切除组织病理学结果进行了比较。汇总所选研究的数据，以总结敏感性、特异性、阳性和阴性LR、诊断比值比以及汇总受试者工作特征（SROC）曲线。
我们纳入了来自15项不同研究的755例接受基于EUS-FNA的细胞学检查并获得组织病理学诊断的患者。诊断恶性PCL的汇总敏感性和特异性分别为0.62（95%CI，0.42-0.78）和0.96（95%CI，0.91-0.98）。诊断恶性PCL的阳性和阴性LR分别为16.3（95%CI，7.2-37.0）和0.40（95%CI，0.25-0.64）。曲线下面积（AUC）为0.94（95%CI，0.91-0.95）。
基于EUS-FNA的细胞学检查在鉴别恶性与良性PCL方面总体具有高特异性、中等敏感性和良好的诊断准确性。需要进一步研究以提高基于EUS-FNA的细胞学检查对恶性PCL诊断的总体敏感性。
