Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: A systematic review and meta-analysis
Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: A systematic review and meta-analysis
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DOI：
10.1016/j.ejca.2008.11.043
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发表时间：
2009-05-01
影响因子：
8.4
通讯作者：
Han, Bao-Hui
中科院分区：
文献类型：
--
作者：
Gu, Ping;Zhao, Yi-Zhuo;Han, Bao-Hui
研究目的：最近，微创方法已成为肺癌疑似转移性纵隔淋巴结组织确认分期的潜在替代方法。本综述的目的是评估EBUS-TBNA在检测肺癌转移性纵隔淋巴结中的总体诊断准确性与荟萃分析。方法：MEDLINE，EMBASE，Cancerlit和科克伦图书馆数据库，从1995年1月至2008年9月，研究评估EBUS-TBNA的准确性。荟萃分析方法被用来池的敏感性和特异性，并构建摘要receiver-operating characteristic.Results：共11项研究，1299例患者，谁满足所有的纳入标准，被认为是分析。EBUS-TBNA的合并敏感性为0.93（95%CI，0.91-0.94），合并特异性为1.00（95%CI，0.99-1.00）。根据CT或PET阳性结果选择的患者亚组的合并敏感性（0.94，95% CI 0.93-0.96）高于未选择任何CT或PET的患者亚组（0.76，95% CI 0.65-0.85）（p < 0.05）。研究敏感性与淋巴结转移的发生率无关。结论：EBUS-TBNA是一种准确、安全、经济的肺癌分期方法。选择CT或PET检查可疑淋巴结转移的患者，可提高EBUS-TBNA的敏感性。关于EBUS-TBNA在肺癌分期中的高质量前瞻性研究仍需进行。(C)2008爱思唯尔有限公司保留所有权利。
Study objectives: Recently, less invasive methods have emerged as potential alternatives for staging with tissue confirmation of suspected metastatic mediastinal lymph nodes in lung cancer. The objective of this review was to assess the overall diagnostic accuracy of EBUS-TBNA in detecting metastatic mediastinal lymph node in lung cancer with a meta-analysis.Methods: The MEDLINE, EMBASE, Cancerlit and Cochrane Library database, from January 1995 to September 2008, were searched for studies evaluating EBUS-TBNA accuracy. Meta-analysis methods were used to pool sensitivity and specificity and to construct summary receiver-operating characteristic.Results: A total of 11 studies with 1299 patients, who fulfilled all of the inclusion criteria, were considered for the analysis. No publication bias was found. EBUS-TBNA had a pooled sensitivity of 0.93 (95% CI, 0.91-0.94) and a pooled specificity of 1.00 (95% CI, 0.99-1.00). The subgroup of patients who were selected on the basis of CT or PET positive results had higher pooled sensitivity (0.94, 95% CI 0.93-0.96) than the subgroup of patients without any selection of CT or PET (0.76, 95% CI 0.65-0.85) (p < 0.05). Study sensitivity was not correlated with the prevalence of lymph node metastasis. Only two complications occurred (0.15%).Conclusion: EBUS-TBNA was an accurate, safe and cost-effective tool in lung cancer staging. The selection of patients who had positive results of suspected lymph node metastasis in CT or PET may improve the sensitivity of EBUS-TBNA. High-quality prospective studies regarding EBUS-TBNA in lung cancer staging are still needed to be conducted. (C) 2008 Elsevier Ltd. All rights reserved.