Diagnostic Efficacy and Safety of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Intrathoracic Tuberculosis: A Meta-analysis.
OBJECTIVE
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique. A meta-analysis was performed to assess the efficacy and safety of EBUS-TBNA in intrathoracic tuberculosis (TB).


METHODS
We searched PubMed, the Cochrane Library, and the Web of Science for suitable studies. The pooled sensitivity, specificity, likelihood ratios (LRs), and diagnostic odds ratio were calculated. A summary receiver operating characteristic (ROC) curve was constructed to calculate the area under the summary ROC curve and Qpoint value (Q*).


RESULTS
A total of 8 studies with 809 patients were included. The pooled sensitivity and specificity of EBUS-TBNA for diagnosis of intrathoracic TB were 0.80 (95% confidence interval [CI] 0.74-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. The positive LR was 38.25 (95% CI, 13.59-107.65); the negative LR was 0.24 (95% CI, 0.17-0.33); and the diagnostic odds ratio was 186.35 (95% CI, 63.57-546.28). The area under the summary ROC curve was 0.935, and the Q*was 0.871. The pooled sensitivity of EBUS-TBNA for diagnosis of intrathoracic tuberculous lymphadenopathy was 0.87 (95% CI, 0.80-0.95). Only 1 serious complication was reported.


CONCLUSIONS
Endobronchial US-guided TBNA is an effective and safe diagnostic tool for intrathoracic TB, especially intrathoracic tuberculous lymphadenopathy.
Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Wu
W
Ye
Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Ruifeng
R
Zhang
Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Xiaoling
X
Xu
Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Yanru
Y
Liu
Department of Respiratory Diseases, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China. yingkj55@126.com.
Kejing
K
Ying
D000328:Adult; D015897:Comorbidity; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D014388:Tuberculosis, Lymph Node / Q000453:epidemiology* / Q000473:pathology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology* / Q000473:pathology*
diagnostic accuracy; endobronchial ultrasound-guided transbronchial needle aspiration; intrathoracic tuberculosis; meta-analysis; tuberculous lymphadenopathy