Review
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Mediastinal Staging of Non-Small Cell Lung Cancer: A Meta-Analysis

https://doi.org/10.1016/j.athoracsur.2013.05.016Get rights and content

In this article, we assessed the pooled sensitivity and specificity of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in studies during the last 10 years that have solely used EBUS-TBNA as a minimally invasive technique, with or without computed tomography or positron-emission tomography screening. The meta-analysis included 1,066 patients from 9 studies who underwent EBUS-TBNA. The results show EBUS-TBNA is a potential technique for the investigation, diagnosis, and staging of non-small cell lung cancer among patients with suspected lung cancer. It has excellent sensitivity, specificity, accuracy, positive predictive value, and negative predictive value. EBUS-TBNA is well tolerated and does not lead to complications in patients.

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Material and Methods

A bibliographic search of medical literature from January 1995 to July 2012 was performed using PubMed, EMBASE, and Web of Science using the search string “endobronchial ultrasound” or “endobronchial ultrasonography” or “EBUS” or “endobronchial ultrasound-guided” and “TBNA” or “transbronchial needle aspiration” and “lung cancer” or “NSCLC” or “Lymphatic metastasis” or “Lung Neoplasm”. The Cochrane Library (www.cochranelibrary.com) was also searched. Reference lists of included studies and

Results

The computerized search identified 168 studies; of these, 107 were excluded on the basis of title or abstract. The full text of 61 articles was retrieved and read by 2 independent authors. Finally, nine studies were included in the meta-analysis (Fig 1) 10, 12, 13, 14, 15, 16, 17, 18, 19. We included clinical trials, prospective, retrospective, and cohort studies in our meta-analysis.

The study characteristics of the included studies are reported in Table 1. Patients were enrolled prospectively

Comment

The present meta-analysis was conducted to evaluate EBUS-TBNA as a tool in the staging of NSCLC. We conducted this meta-analysis and included prospective and retrospective studies (between December 2005 and January 2012) to evaluate the sensitivity, specificity, NPV, PPV, and accuracy of EBUS-TBNA in the diagnosis of mediastinal lymph nodes. The meta-analysis focused only on those studies that included the evaluation of the mediastinum using EBUS-TBNA.

Few of the studies included in the present

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