“…There are previous reports using cytology with pancreatic juice, including repeated cytology of pancreatic juice obtained using an ENPD tube and brush cytology, for diagnosis of highgrade PanINs and small pancreatic cancer. Using repeated cytology with an ENPD tube, Iiboshi et al [6] reported a sensitivity, specificity, and accuracy of detecting highgrade PanIN and small pancreatic cancer of 100, 83.3, and 95%, respectively, while Mikata et al [7] reported a sensitivity, specificity, and accuracy of detecting pancreatic cancer, including advanced pancreatic cancer, of 80, 100, and 87%, respectively, which was significantly higher than the sensitivity, specificity, and accuracy obtained when using single cytology. Further, 1 study reported diagnosis using brush cytology in a high-grade PanIN patient [5] .…”