title: Endobronchial ultrasound versus conventional transbronchial needle aspiration in the diagnosis of mediastinal lymphadenopathy: a meta-analysis.
abstract: Currently, whether endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is superior to conventional TBNA (cTBNA) in the diagnosis of mediastinal lymphadenopathy remains controversial. We undertook a meta-analysis of randomized controlled trials (RCTs) to evaluate the diagnostic yield of EBUS-TBNA versus cTBNA in the diagnosis of mediastinal lymphadenopathy, both in benign and malignant etiologies. Computer-based retrieval was performed on PubMed and EMBASE. The quality was evaluated according to the quality assessment of diagnostic accuracy studies-2, and Meta-Disc was adopted to perform meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95 % confidence intervals (CIs) were calculated. The summary receiving operating characteristic curve as well as the areas under curve (AUC) was measured. Four studies with a total of 440 patients met the inclusion criteria. Our results showed that the pooled sensitivity was 0.90 (95 % CI 0.85-0.94) and 0.76 (95 % CI 0.68-0.82), pooled specificity was 0.75 (95 % CI 0.60-0.87) and 0.94 (95 % CI 0.86-0.98), DOR was 75.38 (95 % CI 16.38-346.97) and 108.17 (95 % CI 13.84-845.35), and AUC was 0.9339 and 0.9732 for EBUS-TBNA group and cTBNA group, respectively. Although EBUS-TBNA with a higher sensitivity performs better than cTBNA, there is lack of enough evidence regarding EBUS-TBNA being superior to cTBNA in the diagnosis of mediastinal lymphadenopathy. Considering the limitations of methodology and limited data, further robust RCTs are needed to verify the current findings and investigate the optimal choice in patients receiving TBNA.
authors: Department of Ultrasonography, Binzhou Medical University Hospital, Binzhou, 256603 China.
authors: Jun-Hong
authors: JH
authors: Yan
authors: Department of Respiratory and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou, 256603 China.
authors: Lei
authors: L
authors: Pan
authors: Department of Critical Care Medicine, Jining First People's Hospital, Jining, 272001 China.
authors: Xiao-Li
authors: XL
authors: Chen
authors: Department of Infection Management, Binzhou Medical University Hospital, Binzhou, 256603 China.
authors: Jian-Wei
authors: JW
authors: Chen
authors: Department of Infection Management, Binzhou Medical University Hospital, Binzhou, 256603 China.
authors: Li-Ming
authors: LM
authors: Yan
authors: Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University, Zhengzhou, 450003 China.
authors: Bao
authors: B
authors: Liu
authors: Department of Respiratory Medicine, Xuzhou Central Hospital, The Affiliated Xuzhou Center Hospital of Nanjing University of Chinese Medicine, 199 South Jiefang Road, Xuzhou, 221009 Jiangsu China.
authors: Yong-Zhong
authors: YZ
authors: Guo
keywords: Diagnostic yield; Endobronchial ultrasound; Mediastinal lymphadenopathy; Meta-analysis; Transbronchial needle aspiration