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

Table 1 Characteristics of included studies

Ref.	Year	LBC technique	Cytological diagnosis classification	Match method	ROSE available	Research type	Outcome	Sample size1	Number of puncture	FNA needle size, gauge
van Riet et al[6]	2016	TP and/or CB	Bethesda	Homology	No	Prospective	LBC = SC	71	1	19/22/25
Chun et al[8]	2020	SP	Common	Homology	NA1	Prospective	LBC = SC	169 (160/166)	≥ 3	19/22
Zhou et al[12]	2020	SP	PSC	Homology	No	Retrospective	SC + LBC > LBC > SC	514	≥ 3	22/25
Shih et al[23]	2019	NA	Common	Homology	NA	Prospective	LBC > SC	9	NA	NA
Yeon et al[5]	2018	CP and CB	Common	Homology	No	Prospective	LBC < SC	48	≥ 3	22
Hashimoto et al[22]	2017	SP and CB	Common	Heterology	No	Retrospective	LBC > SC	63	≥ 3	19/22/25
Qin et al[21]	2014	TP and CB	Common	Homology	No	Prospective	LBC > SC	72	≥ 3	22
Lee et al[20]	2011	TP	Common	Homology	No	Prospective	LBC < SC	58	≥ 3	22/25
LeBlanc et al[19]	2010	TP	Common	Homology	Yes	Prospective	LBC < SC	50	≥ 3	22
de Luna et al[18]	2004	TP	Common	Homology	Yes	Retrospective	LBC < SC	67 (62/51)	NA	NA

¹In two of the studies (Chun et al[8] and de Luna et al[18]), inadequate cytological samples were excluded from the final analysis.

CB: Cell block; CP: Cell prep plus; FNA: Fine-needle aspiration; LBC: Liquid-based cytology; NA: Not available; PSC: Papanicolaou society of cytopathology; ROSE: Rapid On-Site Evaluation; SC: Smear cytology; SP: Sure path; TP: Thin prep.

Table 2 Meta-regression analysis of sensitivity of smear cytology

Parameter	Category	Studies, n	Sensitivity	P value
Type	Prospective	7	0.83 (0.74-0.92)	0.71
	Retrospective	3	0.65 (0.47-0.84)
Subject	≥ 50	8	0.78 (0.68-0.89)	0.67
	< 50	2	0.80 (0.56-1.00)
Match	Homology	9	0.80 (0.70-0.89)	0.48
	Heterology	1	0.64 (0.27-1.00)
ROSE	Without ROSE	8	0.74 (0.64-0.85)	0.03
	With ROSE	2	0.90 (0.80-1.00)
LBC	TP	5	0.83 (0.72-0.94)	0.87
	SP/CP	5	0.73 (0.58-0.88)
Classification	Common	5	0.86 (0.77-0.95)	0.94
	Other1	5	0.71 (0.58-0.84)

¹Includes common cytological diagnosis classification methods that lack adequate cytological samples; these samples were excluded from the final analysis.

CP: Cell prep plus; LBC: Liquid-based cytology; ROSE: Rapid On-Site Evaluation; SP: Sure path; TP: Thin prep.

Table 3 Meta-regression analysis of sensitivity of liquid-based cytology

Parameter	Category	Studies, n	Sensitivity	P value
Type	Prospective	7	0.75 (0.67-0.84)	0.12
	Retrospective	3	0.75 (0.63-0.87)
Subject	≥ 50	8	0.77 (0.70-0.83)	0.85
	< 50	2	0.68 (0.46-0.89)
Match	Homology	9	0.74 (0.67-0.80)	0.01
	Heterology	1	0.90 (0.80-1.00)
ROSE	Without ROSE	8	0.79 (0.73-0.84)	0.80
	With ROSE	2	0.60 (0.44-0.76)
LBC	TP	5	0.70 (0.61-0.80)	0.00
	SP/CP	5	0.80 (0.73-0.88)
Classification	Common	5	0.74 (0.64-0.85)	0.05
	Others1	5	0.76 (0.67-0.85)

¹Includes common cytological diagnosis classification methods that lack adequate cytological samples; these samples were excluded from the final analysis.

CP: Cell prep plus; LBC: Liquid-based cytology; ROSE: Rapid On-Site Evaluation; SP: Sure path; TP: Thin prep.