title: Minimally invasive endoscopic staging for mediastinal lymphadenopathy in lung cancer: a systematic review protocol.
abstract: BACKGROUND
  Minimally invasive endoscopic biopsy techniques have been widely available as potential alternatives for mediastinal lesions staging in patients with known or suspected lung cancer. Previous efforts have been made to evaluate the diagnostic performance of specific endoscopic modality alone at the level of the mediastinum for staging lung cancer, however, few studies focus on the accuracy of comparisons between different endoscopic modalities, especially at the level of any individual lymph node station. The objective of our study is to determine the diagnostic yields of different endoscopic modalities for staging mediastinal lymphadenopathy in lung cancer, especially concerning the individual lymph node station.
  
  
  METHODS
  A systematic electronic search of MEDLINE, EMBASE, SinoMed and ISI Web of Science were performed to identify studies evaluating endoscopic modalities accuracy with restriction of English and Chinese languages from inception to an update until May 2014. Data were extracted with the patient as the unit of analysis with regards to the abilities of different endoscopic modalities at the level of mediastinum and particular lymph node station. The methodological quality was assessed independently according to the Quality Assessment of Diagnostic Accuracy Study (QADAS) criteria. An exact binomial rendition of bivariate mixed-effects regression model was used to estimate the pooled sensitivity and specificity. Also, pre-post probability analysis, publication bias analysis and sensitivity analysis were performed for a synthesis of knowledge of this context.
  
  
  RESULTS
  The findings will advance our better available knowledge of optimal clinical decision-making when dealing with staging of mediastinal metastasis in lung cancer.
  
  
  BACKGROUND
  PROSPERO-NIHR Prospective Register of Systematic Reviews (CRD42014009792).
authors.affiliation: Department of Cardiothoracic Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Ultrasonography, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Key Laboratory of Diagnostic Medicine of Education Ministry, Institute of Laboratory Medicine, Chongqing Medical University, Chongqing, China.
authors.forename: Qiao-ling
authors.initials: QL
authors.lastname: Feng
authors.affiliation: Department of Radiation Oncology, Affiliated Cancer Hospital of Guangxi Medical University, Nanning, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wan
authors.affiliation: National Center for Medical Simulation of China, Chengdu Medical College, Chengdu, China Department of Histo-anatomy, School of Basic Medical Sciences, Chengdu Medical College, Chengdu, China.
authors.forename: Yong-jun
authors.initials: YJ
authors.lastname: Xie
authors.affiliation: Department of Cardiothoracic Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Hai-tao
authors.initials: HT
authors.lastname: Gu
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis*; D008206:Lymphatic Diseases / Q000473:pathology*; D008477:Mediastinal Diseases / Q000473:pathology*; D019060:Minimally Invasive Surgical Procedures; D009367:Neoplasm Staging / Q000379:methods*; D011446:Prospective Studies; D000078202:Systematic Reviews as Topic
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