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Diagnostic efficacy and safety of endobronchial ultrasoundguided transbronchial needle aspiration in intrathoracic tuberculosis: a meta analysis

  

  1. Department  of Respiratory Disease Intervention, Wuhan Jinyintan Hospital, Wuhan Medical Treatment Center, Wuhan 430023, China
  • Online:2018-12-05 Published:2019-01-17
  • Contact: Corresponding author:Chen Huidong,Email:14043833646@qq.com

Abstract: Objective  To evaluate the efficacy and safety of Endobronchial UltrasoundGuided Transbronchial Needle Aspiration (EBUSTBNA) in Intrathoracic Tuberculosis(TB).Methods  Qualified studies were retrieved from PubMed and the Cochrane Library. Metadisc sofeware was applied to date analysis. The pooled sensitivity, specificity, likelihood ratios, the area under the summary receiver operating characteristic(ROC)and Q point(Q*) were calculated. And Metaregression was used to analyze the heterogeneity. Results  Ultimately 19 studies with 1784 patients were included. The pooled sensitivity and specificity of EBUSTBNA for diagnosis of intrathoracic TB were 0.78 (95% confidence interval [CI],0.740.81) and 1.00 (95%CI=0.991.00), respectively. The positive LR was 54.61(95%CI=30.5797.57);  and the negative LR was 0.24 (95%CI=0.190.31). The area under the summary ROC curve was 0.943, and the Q* was 0.881. Metaregression showed that region difference and research type were associated with heterogeneity, the sensitibity of EBUSTBNA for diagnosis of intrathoracic TB in European was 0.17 (95%CI=0.030.83, P=0.03)  higher than in Asian, prospective study with high sensitibility of   0.20(95%CI=0.040.95,P=0.04)  compared with the retrospective.The difference was statistically significant. Only 1 serious complication of septicopymia occurred. Conclusion  EBUSTBNA is an effective and safe diagnostic tool for intrathoracic TB, especially in patients with negetive sputum of mycobacterium tuberculosis and intrathoracic lymphadenopathy.

Key words: endobronchial ultrasound, needle aspiration, intrathoracic tuberculosis; , metaanalysis