“…Aspirated cyst fluid occasionally does not contain enough PCL cellular material. A meta-analysis of EUS-FNA for diagnosing PCL, including 18 studies and a total of 1438 patients, showed a pooled sensitivity and specificity of cytological diagnostic capability for differentiating mucinous from non-mucinous cysts as 54% (95% CI, [49][50][51][52][53][54][55][56][57][58][59] and 93% (95% CI, 90-95), respectively. 40 A recent systematic review for the detection of malignant IPMN, including 193 studies with 12,297 patients, showed cyst fluid cytology as area under the curve of 0.84, sensitivity of 54% and specificity of 91% to identify malignant IPMN.…”