Endoscopic ultrasound-guided through-the-needle microforceps biopsy and needle-based confocal laser-endomicroscopy increase detection of potentially malignant pancreatic cystic lesions: A single-center study

Table 3 Overall diagnostic accuracy for determining malignancy [% (95%CI)]

	EUS alone (n = 47)	EUS + FNA/CE/ Cystoscopy (n = 28)	EUS + mFB (n = 36)	EUS + nCLE (n = 44)	EUS + nCLE + mFB (n = 26)
Sensitivity	7/7; 100.0% (59.3-100.0)	10/11; 90.9% (58.7-99.8)	7/8; 87.5% (47.3-99.7)	8/9; 88.8%; (51.8-99.7)	7/7; 100.0% (59.0-100.0)
Specificity	1/40; 2.5% (0.1-13.2)	8/17; 47.1% (22.9-72.3)	23/28; 82.1% (63.1-93.9)	30/35; 85.7% (69.7-95.2)	17/19; 89.4% (66.9-98.7)
PPV	7/46; 15.2% (6.3-28.9)	10/19; 52.6% (28.9-75.6)	7/12; 58.3% (27.7-84.8)	8/13; 61.5% (31.6-86.1)	7/9; 77.8% (40.0-97.1)
NPV	1/1; 100.0% (2.5-100.0)	8/9; 88.9% (51.8-99.7)	23/24; 95.8% (78.9-99.8)	30/31; 97% (83-100)	17/17; 100.0% (80.5-100.0)
PLR	1.03 (0.98-1.08)	1.72 (1.06-2.79)	4.90 (2.12-11.31)	6.22 (2.68-14.47)	9.50 (2.56-35.24)
NLR	n/a	0.19 (0.03-1.34)	0.15 (0.02-0.96)	0.13 (0.02-0.83)	n/a
Observed agreement	8/47 (17%); P = 0.672a	18/28 (64.3%); P = 0.049a	30/36 (83.3%); P < 0.001a	38/44 (86.4%); P < 0.001a	24/26 (92.3%); P < 0.001a
MCC	+ 0.06	+ 0.40	+ 0.61	+ 0.66	+ 0.83
AU-ROC	51.3%; P = 0.359b	69.0%; P = 0.02b	84.8%; P < 0.001b	87.3%; P < 0.001b	94.7%; P < 0.001b

^aFisher's exact test for count data.

^bMann–Whitney U test.

EUS: Endoscopic ultrasound; nCLE: Confocal laser endomicroscopy; mFB: Endoscopic ultrasound-guided through-the-needle direct intracystic micro forceps biopsy; PPV: Positive predictive value; NPV: Negative predictive value; PLR: Positive likelihood ratio; NLR: Negative likelihood ratio; MCC: Matthews correlation coefficient; AU-ROC: Area under the receiver operating characteristics curve; n/a: Not available.