Department of Ultrasound, The Affiliated Dongyang Hospital of Wenzhou Medical University, No. 60 Wuning West Road, Dongyang 322100 , Zhejiang, China.
Med Ultrason. 2022 Feb 16;24(1):85-94. doi: 10.11152/mu-2971. Epub 2021 Apr 1.
In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs).
A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs.
Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88).
EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.
本研究通过荟萃分析评估支气管内超声（EBUS）弹性成像对鉴别良恶性肺门和纵隔淋巴结（LNs）的诊断价值。
通过 PubMed、Embase 和 Cochrane Library 进行全面文献检索。两名作者独立筛选论文并提取数据，如果存在分歧则通过讨论解决。使用诊断准确性研究质量评估工具 2 评估每个纳入研究的方法学质量。通过计算 EBUS 弹性成像对肺门和纵隔 LNs 的敏感性、特异性、阳性似然比、阴性似然比和曲线下面积来评估其价值。
纳入了 17 项研究，共计 2307 个 LNs。纳入研究之间存在显著异质性。EBUS 弹性成像诊断肺门和纵隔 LNs 的汇总敏感性、特异性、阳性似然比、阴性似然比和诊断比值比分别为 0.90（95%置信区间[CI]，0.84-0.94）、0.78（95% CI，0.74-0.81）、4.1（95% CI，3.4-4.9）、0.12（95% CI，0.07-0.21）和 33（95% CI，17-64）。此外，曲线下面积计算为 0.86（95% CI，0.82-0.88）。
EBUS 弹性成像在鉴别肺门和纵隔良恶性 LNs 方面是一种有价值的技术，可以在支气管内超声引导下经支气管针吸活检过程中提供补充的诊断信息。EBUS 弹性成像与 B 模式 EBUS 的结合可以提高肺门和纵隔 LNs 的诊断准确性。
