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.
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.
Authors: Emily A DuComb; Benjamin A Tonelli; Ya Tuo; Bernard F Cole; Vitor Mori; Jason H T Bates; George R Washko; Raúl San José Estépar; C Matthew Kinsey Journal: Chest Date: 2020-06-26 Impact factor: 9.410
Authors: Christoph Frank Dietrich; Jouke Tabe Annema; Paul Clementsen; Xin Wu Cui; Mathias Maximilian Borst; Christian Jenssen Journal: J Thorac Dis Date: 2015-09 Impact factor: 2.895
Authors: Christian Jenssen; Jouke Tabe Annema; Paul Clementsen; Xin-Wu Cui; Mathias Maximilian Borst; Christoph Frank Dietrich Journal: J Thorac Dis Date: 2015-10 Impact factor: 2.895
Authors: Ad F Verhagen; Olga C J Schuurbiers; Monika G Looijen-Salamon; Stefan M van der Heide; Henry A van Swieten; Erik H F M van der Heijden Journal: Interact Cardiovasc Thorac Surg Date: 2013-07-09
Authors: David E Ost; Armin Ernst; Xiudong Lei; David Feller-Kopman; George A Eapen; Kevin L Kovitz; Felix J F Herth; Michael Simoff Journal: Chest Date: 2011-06-09 Impact factor: 9.410