Procedures: Procedures: Bronchoscopy |

Diagnostic Value of EBUS-TBNA vs C-TBNA in the Diagnosis of Mediastinal Masses: A Systematic Review and Meta-analysis FREE TO VIEW

Lei Pan, PhD; Guo-Gang Xu, PhD; Jun Guo, PhD; Yongzhong Guo; Changting Liu
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Affiliated Hospital of Binzhou Medical University, Chinese PLA General Hospital, Binzhou, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A434. doi:10.1016/j.chest.2016.02.452
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SESSION TITLE: Procedures: Bronchoscopy

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To evaluate the diagnostic value of endobronchial ultrasound vs. conventional transbronchial needle aspiration in the diagnosis of mediastinal masses.

METHODS: Computer-based retrieval was performed on PubMed, EMBASE, Cochrane Library, CBM, and CNKI (up to Apr 2015). Randomized controlled trials that compared conventional transbronchial needle aspiration (C-TBNA) and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis of patients with mediastinal masses were included. The quality of included trials was evaluated according to quality assessment of diagnostic accuracy studies-2 (QUADAS-2), and MetaDisc software (Version 1.4) was adopted to perform meta-analysis. The pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated. The summary receiving operating characteristic (SROC) curve as well as the areas under curve (AUC) was measured.

RESULTS: Five studies with a total of 522 patients met the inclusion criteria. Meta-analysis showed that pooled sensitivity was 0.78 (95% confidence interval [CI], 0.71 to 0.84) and 0.90 (95% CI, 0.85 to 0.93), pooled specificity was 0.99 (95% CI, 0.92 to 1.00) and 0.93 (95% CI, 0.81 to 0.99), DOR was 113.98 (95% CI, 14.81 to 877.46) and 97.39 (95% CI, 18.52 to 512.20), and AUC was 0.98 and 0.96 for C-TBNA group and EBUS-TBNA group, respectively.

CONCLUSIONS: Both EBUS-TBNA and C-TBNA are safe and provide good diagnostic value for mediastinal masses; however, EBUS-TBNA with a higher sensitivity performs better compared to C-TBNA. Further robustly designed studies are needed to investigate the role of EBUS-TBNA in lung disease and/or mediastinal masses.

CLINICAL IMPLICATIONS: In terms of either EBUS-TBNA or C-TBNA, the clinicians need to follow the principle of individual selection, and the financial burden may be one of the issues needed to consider for the clinicians.

DISCLOSURE: The following authors have nothing to disclose: Lei Pan, Guo-Gang Xu, Jun Guo, Yongzhong Guo, Changting Liu

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