肺癌纵隔分期中联合应用EBUS-TBNA和EUS-FNA的Meta分析

Test Performance of Combined Endobronchial and Endoesophageal Ultrasound-Guided Fine-Needle Aspiration for Mediastinal Staging of Lung Cancer:A Meta-Analysis

目的支气管内镜超声引导下经支气管针吸活检(EBUS-TBNA)和经食管超声引导下针吸活检(EUS-FNA)在检查纵隔淋巴结上具有互补性,两者联用可以获得更完整和更准确的纵隔淋巴结分期。通过Meta分析的方法分析两者联用后在诊断肺癌纵隔淋巴结转移上的敏感性和特异性。方法在MEDLINE数据库进行检索,所有符合联合应用EBUS-TBNA和EUS-FNA诊断肺癌纵隔淋巴结有无转移的研究纳入分析。使用Meta-DiSc软件计算总的敏感性和特异性。结果共6项研究符合条件纳入分析,研究之间不存在异质性,应用固定效应模型计算,总的敏感性和特异性分别为0.90(95%可信区间0.86～0.94)和0.99(95%可信区间0.98～1.00)。结论在肺癌纵隔淋巴结分期中联合应用EBUS-TBNA和EUS-FNA具有非常高的敏感性和特异性。

Objective Owing to the complementary reach of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） and transoesophageal ultrasound-guided fine-needle aspiration （EUS-FNA） in assessing different regions of the mediastinum, it suggested that complete and accurate mediastinal staging may be achieved by the combination of both procedures. A systematic review was performed of published studies evaluating combined EBUS-TBNA and EUS-FNA for mediastinal lymph node staging to ascertain the pooled sensitivity and specificity of this investigation. Methods MEDLINE were searched for studies evaluating combined EBUS-TBNA and EUS-FNA accuracy in mediastinal staging with no language restriction. Meta-DiSc software was used to calculate pool sensitivity and specificity. Results Six studies met inclusion criteria and had data suitable for extraction and analysis. Using a fixed effects model, the pooled sensitivity and specificity were 0.90（95%CI 0.86-0.94）, 0.99（95%CI 0.98- 1.00）, respectively. Conclusions Combined EBUS-TBNA and EUS-FNA has exeellent overall sensitivity and specificity for mediastinal lymph node staging in patients with lung cancer.