title: The value of autofluorescence bronchoscopy combined with white light bronchoscopy compared with white light alone in the diagnosis of intraepithelial neoplasia and invasive lung cancer: a meta-analysis.
abstract: OBJECTIVE
  To compare the accuracy of autofluorescence bronchoscopy (AFB) combined with white light bronchoscopy (WLB) versus WLB alone in the diagnosis of lung cancer.
  
  
  METHODS
  The Ovid, PubMed, and Google Scholar databases from January 1990 to October 2010 were searched. Two reviewers independently assessed the quality of the trials and extracted data. The relative risk for sensitivity and specificity on a per-lesion basis of AFB + WLB versus WLB alone to detect intraepithelial neoplasia and invasive cancer were pooled by Review Manager.
  
  
  RESULTS
  Twenty-one studies involving 3266 patients were ultimately analyzed. The pool relative sensitivity on a per-lesion basis of AFB + WLB versus WLB alone to detect intraepithelial neoplasia and invasive cancer was 2.04 (95% confidence interval [CI] 1.72-2.42) and 1.15 (95% CI 1.05-1.26), respectively. The pool relative specificity on a per-lesion basis of AFB + WLB versus WLB alone was 0.65 (95% CI 0.59-0.73).
  
  
  CONCLUSIONS
  Although the specificity of AFB + WLB is lower than WLB alone, AFB + WLB seems to significantly improve the sensitivity to detect intraepithelial neoplasia. However, this advantage over WLB alone seems much less in detecting invasive lung cancer.
authors.affiliation: Pulmonary Department, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, People's Republic of China.
authors.forename: Jiayuan
authors.initials: J
authors.lastname: Sun
authors.forename: David H
authors.initials: DH
authors.lastname: Garfield
authors.forename: Bing
authors.initials: B
authors.lastname: Lam
authors.forename: Jingjing
authors.initials: J
authors.lastname: Yan
authors.forename: Aiqin
authors.initials: A
authors.lastname: Gu
authors.forename: Jie
authors.initials: J
authors.lastname: Shen
authors.forename: Baohui
authors.initials: B
authors.lastname: Han
mesh_terms: D001999:Bronchoscopy; D002278:Carcinoma in Situ / Q000175:diagnosis*; D005453:Fluorescence; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000175:diagnosis*; D011379:Prognosis; D012680:Sensitivity and Specificity