title: Diagnostic Value of Convex Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Mediastinal Tuberculous Lymphadenitis: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been widely used in the diagnosis of mediastinal lymphadenopathies. Here, we performed a systematic review and meta-analysis to explore the diagnostic value of EBUS-TBNA in mediastinal tuberculous lymphadenopathy (TBLA).
  
  
  METHODS
  PubMed, EMBASE, and Sinoced were systematically searched for articles published in English or Chinese that reported the diagnostic yield of EBUS-TBNA in mediastinal TBLA. The quality of studies was assessed using the QualSyst tool. Using 95% confidence intervals (CI), the diagnostic yields of EBUS-TBNA were calculated for the individual studies, and the results were then pooled using a random-effects model. Heterogeneity and publication bias were also assessed.
  
  
  RESULTS
  A total of 14 studies, consisting of 684 patients with mediastinal TBLA, were finally included. The pooled diagnostic yield of EBUS-TBNA for mediastinal TBLA was 80% (95% CI: 74-86%). Significant heterogeneity (I2=77.9%) and significant publication bias were detected (Begg's test p=0.05 and Egger's test p=0.02). From subgroup analyses, significant differences in the diagnostic yield of EBUS-TBNA were associated with Asian vs. European (UK) studies, retrospective vs. prospective studies, those employing rapid on-site cytological evaluation vs. not, those employing different anesthetic types, and those employing smear vs. culture. However, microbiological examination and the number of lymph node passes did not have a significant effect on the diagnostic yield of EBUS-TBNA. Fifteen minor complications for EBUS-TBNA were reported.
  
  
  CONCLUSIONS
  EBUS-TBNA appears to be an efficacious and safe procedure and should be used as an initial diagnostic tool for mediastinal TBLA.
authors.affiliation: Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Respiratory Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China (mainland).
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Epidemiology and Health Statistics, Bengbu Medical College, Bengbu, Anhui, China (mainland).
authors.forename: Wenjia
authors.initials: W
authors.lastname: Peng
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods; D008477:Mediastinal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014463:Ultrasonography / Q000379:methods