Diagnostic Efficacy and Safety of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in Intrathoracic Tuberculosis: A Meta-analysis.

OBJECTIVES:Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique. A meta-analysis was performed to assess the efficacy and safety of EBUS-TBNA in intrathoracic tuberculosis (TB). METHODS:We searched PubMed, the Cochrane Library, and the Web of Science for suitable studies. The pooled sensitivity, specificity, likelihood ratios (LRs), and diagnostic odds ratio were calculated. A summary receiver operating characteristic (ROC) curve was constructed to calculate the area under the summary ROC curve and Qpoint value (Q*). RESULTS:A total of 8 studies with 809 patients were included. The pooled sensitivity and specificity of EBUS-TBNA for diagnosis of intrathoracic TB were 0.80 (95% confidence interval [CI] 0.74-0.85) and 1.00 (95% CI, 0.99-1.00), respectively. The positive LR was 38.25 (95% CI, 13.59-107.65); the negative LR was 0.24 (95% CI, 0.17-0.33); and the diagnostic odds ratio was 186.35 (95% CI, 63.57-546.28). The area under the summary ROC curve was 0.935, and the Q*was 0.871. The pooled sensitivity of EBUS-TBNA for diagnosis of intrathoracic tuberculous lymphadenopathy was 0.87 (95% CI, 0.80-0.95). Only 1 serious complication was reported. CONCLUSIONS:Endobronchial US-guided TBNA is an effective and safe diagnostic tool for intrathoracic TB, especially intrathoracic tuberculous lymphadenopathy.