Background

EBUS is being widely used today for echolocation of lymph nodes for FNAC. We present a systematic review and meta-analysis to assess the diagnostic accuracy of EBUS characteristics of lymph nodes in diagnosing malignancy.

Methods

A systematic search of published literature was undertaken using databases like PubMed, Web of Science, Cochrane, Google Scholar and Researchgate. Those studies reporting any endobronchial ultrasonography features of malignant lymph nodes like size, margins, echogenicity, shape, central hilar structure (CHS), coagulation necrosis sign (CNS) or color power doppler index (CPDI) were included for review. Random effects model was used to calculate pooled sensitivity, specificity, positive and negative likelihood ratios (LR), and diagnostic odds ratio (DOR). The review protocol was registered with the International prospective register of systematic reviews (PROSPERO registration no. CRD42019117716).

Results

992 articles were retrieved of which 542 articles were evaluated in detail and finally 29 articles met the inclusion criteria. All EBUS features except CPDI showed a statistically significant area under the SROC curve. CNS showed highest area under the SROC curve [0.81 (SE: 0.09)] with maximum pooled specificity [0.93, 95%CI: 0.92–0.94], maximum pooled LR+ [5.12, 95%CI: 2.56–10.2] and DOR [9.23, 95%CI 3.85–22.15]. Maximum sensitivity was seen for CHS 0.91 [95%CI: 0.90–0.92].

Conclusion

EBUS features have the potential to help in more precise location of a malignant lymph node thereby helping in increasing the diagnostic yield. However, high diagnostic accuracy of various EBUS features can currently only be said to supplement tissue diagnosis.

中文翻译：

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支气管内超声（EBUS）功能在鉴别恶性和良性淋巴结中的诊断作用-系统评价和荟萃分析。

背景

今天，EBUS被广泛用于FNAC淋巴结的回声定位。我们目前进行系统的审查和荟萃分析，以评估淋巴结的EBUS特征在诊断恶性肿瘤中的诊断准确性。

方法

使用PubMed，Web of Science，Cochrane，Google Scholar和Researchgate等数据库对出版的文献进行了系统的搜索。那些研究报告了恶性淋巴结的支气管内超声检查特征，如大小，边缘，回声，形状，中央肺门结构（CHS），凝血坏死征象（CNS）或彩色多普勒指数（CPDI）。随机效应模型用于计算合并的敏感性，特异性，阳性和阴性似然比（LR）和诊断比值比（DOR）。审查协议已在国际预期的系统审查登记簿中注册（PROSPERO注册号CRD42019117716）。

结果

共检索到992篇文章，其中详细评估了542篇文章，最终有29篇文章符合纳入标准。除CPDI外，所有EBUS功能均在SROC曲线下显示出统计学上显着的面积。中枢神经系统显示SROC曲线下面积最大[0.81（SE：0.09）]，最大合并特异性[0.93，95％CI：0.92-0.94]，最大合并LR + [5.12，95％CI：2.56-10.2]和DOR [9.23] ，95％CI 3.85–22.15]。CHS为0.91 [95％CI：0.90-0.92]，具有最高灵敏度。

结论

EBUS功能有可能有助于更精确地定位恶性淋巴结，从而有助于提高诊断率。但是，目前只能说各种EBUS功能的高诊断精度可以补充组织诊断。