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Review
. 2021 Aug 6;11(8):1427.
doi: 10.3390/diagnostics11081427.

The Role of Fine Needle Aspiration Cytology in the Diagnosis of Gallbladder Cancer: A Systematic Review

Georgios D Koimtzis  1 , Christopher G Chalklin  1 , Eliot Carrington-Windo  1 , Mark Ramsden  1 , Leandros Stefanopoulos  2 , Christoforos S Kosmidis  3
Affiliations
Review

The Role of Fine Needle Aspiration Cytology in the Diagnosis of Gallbladder Cancer: A Systematic Review

Georgios D Koimtzis et al. Diagnostics (Basel). .

Abstract

Gallbladder cancer is the most common malignancy of the biliary tract. When diagnosed in an advanced stage it has a very poor prognosis. Therefore, early diagnosis and thorough assessment of a suspicious gallbladder polyp is essential to improve survival rate. The aim of this systematic review is to assess the role of fine needle aspiration cytology (FNAC) in the management of gallbladder cancer. For that purpose, a systematic review was carried out in the MEDLINE, EMBASE, Cochrane, Scopus and Google Scholar databases between 1 July 2004 and 22 April 2021. Six studies with 283 patients in total were included. Pooled sensitivity and specificity of FNAC were 0.85 and 0.94, respectively, while the area under the calculated summary receiver operating characteristic (SROC curve (AUC) was 0.98. No complications were reported. Based on the high diagnostic performance of FNAC in the assessment of gallbladder masses, we suggest that every suspicious mass should be evaluated further with FNAC to facilitate the most appropriate management.

Keywords: cancer; diagnosis; fine needle aspiration cytology; gallbladder.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart depicting the selection process for inclusion of manuscripts in the study.
Figure 2
Figure 2
Funnel plot with pseudo 95% confidence intervals, using data from the six studies, with log-diagnostic-odds-ratios displayed in the horizontal axis, indicating that there was probably no publication bias in the included studies.
Figure 3
Figure 3
Forest plot showing study-specific [15,16,17,18,19] and pooled sensitivity and specificity with corresponding heterogeneity statistics.
Figure 4
Figure 4
SROC curve of the performance of FNAC in the evaluation of gallbladder masses.
Figure 5
Figure 5
The suggested “Cardiff-Thessaloniki” modification to the management of high-risk gallbladder polyps and/or suspicious gallbladder lesions.
See this image and copyright information in PMC

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