Post written by Kai-xuan Wang, MD, PhD, from the Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.

The objective of this article was to compare the diagnostic efficacy of liquid-based cytology (LBC) and smear cytology (SC) in diagnosing solid pancreatic lesions. The diagnostic efficacy of SC and LBC for cytological samples obtained by EUA-FNA is still controversial. In our clinical experience, we were under the impression that the diagnostic accuracy of LBC was higher than that of SC, but no statistical analysis was performed before. Thus, we conducted this study to verify our thoughts.

We found that LBC was more accurate and sensitive than SC in EUS-FNA of pancreatic lesions with higher NPV. The LBC test in our study applied the SurePath method, the mechanism of cell enrichment of which differs from the ThinPrep method applied in some other studies. The SurePath method applies gravity sedimentation and electrical adhesion instead of membrane filtration, which allows a greater degree of preservation of the cell obtained by FNA. A meta-analysis indicated that the SurePath method has significantly fewer unsatisfactory smears than the ThinPrep method for cervical cytology. We think that the 2 LBC methods should be compared for diagnosing of pancreatic lesions.

According to our statistics, the combination of LBC and SC can improve the diagnostic accuracy. However, in clinical practice, there may be a shortage of cell samples, and combination tests may reduce the accuracy. We believe LBC is a better choice under the circumstances.

FIgure 1. Patient inclusion and exclusion flow chart. LBC, Liquid-based cytology; SC, smear cytology; G, gauge.

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