PDF(Pubmed)
Abstract：
UNASSIGNED: Endobronchial ultrasound (EBUS)-guided mediastinal/hilar cryobiopsy (MedCryoBx) is a relatively new modality, being combined with EBUS-transbronchial needle aspiration (TBNA) to improve yield in the diagnosis of intrathoracic adenopathy. This meta-analysis aims to investigate the diagnostic yield of MedCryoBx versus EBUS-TBNA for intrathoracic adenopathy.
UNASSIGNED: We conducted a systematic search using Google Scholar, Embase, and PubMed/MEDLINE for studies about a diagnosis of intrathoracic adenopathy using MedCryoBx and EBUS-TBNA. Two authors separately reviewed studies for inherent bias using the Quality Assessment Data Abstraction and Synthesis-2 (QUADAS-2) tool. Inverse Variance weighting for random effects methodology was used for meta-analysis. Pooled diagnostic yields overall and for subgroups were estimated. Complications of MedCryoBx were reviewed.
UNASSIGNED: Ten studies with 844 patients undergoing either biopsy procedure were in the final analysis. A total of 554 patients underwent MedCryoBx and 704 patients EBUS-TBNA. Meta-analysis showed a pooled diagnostic yield of 91% (504 of 554) for MedCryoBx and 81% (567 of 704) for EBUS-TBNA, with odds ratio (OR) of 2.5 [95% confidence interval (CI): 1.6 to 3.91; P<0.001], with I2 of 20%. Subgroup analysis for benign conditions showed increased diagnostic yield with OR of 7.95 (91% MedCryoBx versus 58% EBUS-TBNA, P<0.001) with an I2 of 25%. Subgroup analysis for lymphoma showed a statistically significant increase in pooled diagnostic yield with OR of 11.48 (87% MedCryoBx versus 29% EBUS-TBNA, P=0.001). Mild bleeding (36.5%) without any intervention was the most common complication. Bleeding requiring intervention (0.7%) was noted in patients. Pneumothorax (0.4%) and pneumomediastinum (0.4%) were less common in this analysis.
UNASSIGNED: MedCryoBx is a very promising tool for the diagnosis of intrathoracic adenopathy. It has improved diagnostic yield over EBUS-TBNA in benign and possibly lymphoproliferative diseases, but less so in lung cancer. The complication rates with MedCryoBx are comparable to EBUS-TBNA.
UNASSIGNED: We conducted a systematic search using Google Scholar, Embase, and PubMed/MEDLINE for studies about a diagnosis of intrathoracic adenopathy using MedCryoBx and EBUS-TBNA. Two authors separately reviewed studies for inherent bias using the Quality Assessment Data Abstraction and Synthesis-2 (QUADAS-2) tool. Inverse Variance weighting for random effects methodology was used for meta-analysis. Pooled diagnostic yields overall and for subgroups were estimated. Complications of MedCryoBx were reviewed.
UNASSIGNED: Ten studies with 844 patients undergoing either biopsy procedure were in the final analysis. A total of 554 patients underwent MedCryoBx and 704 patients EBUS-TBNA. Meta-analysis showed a pooled diagnostic yield of 91% (504 of 554) for MedCryoBx and 81% (567 of 704) for EBUS-TBNA, with odds ratio (OR) of 2.5 [95% confidence interval (CI): 1.6 to 3.91; P<0.001], with I2 of 20%. Subgroup analysis for benign conditions showed increased diagnostic yield with OR of 7.95 (91% MedCryoBx versus 58% EBUS-TBNA, P<0.001) with an I2 of 25%. Subgroup analysis for lymphoma showed a statistically significant increase in pooled diagnostic yield with OR of 11.48 (87% MedCryoBx versus 29% EBUS-TBNA, P=0.001). Mild bleeding (36.5%) without any intervention was the most common complication. Bleeding requiring intervention (0.7%) was noted in patients. Pneumothorax (0.4%) and pneumomediastinum (0.4%) were less common in this analysis.
UNASSIGNED: MedCryoBx is a very promising tool for the diagnosis of intrathoracic adenopathy. It has improved diagnostic yield over EBUS-TBNA in benign and possibly lymphoproliferative diseases, but less so in lung cancer. The complication rates with MedCryoBx are comparable to EBUS-TBNA.
摘要：
■支气管内超声（EBUS）引导的纵隔/肺门冷冻活检（MedCryoBx）是一种相对较新的方式，结合EBUS-经支气管针吸活检术（TBNA），以提高胸内腺病的诊断率。这项荟萃分析旨在研究MedCryoBx与EBUS-TBNA对胸内腺病的诊断率。
■我们使用GoogleScholar进行了系统的搜索，Embase,和PubMed/MEDLINE用于使用MedCryoBx和EBUS-TBNA诊断胸内腺病的研究。两位作者使用质量评估数据抽象和合成-2（QUADAS-2）工具分别审查了固有偏倚的研究。随机效应的逆方差加权方法用于荟萃分析。估计了总体和亚组的汇总诊断率。对MedCryoBx的并发症进行了回顾。
■对844例患者进行活检的10项研究进行了最终分析。共有554名患者接受了MedCryoBx和704名患者接受了EBUS-TBNA。荟萃分析显示，MedCryoBx的合并诊断率为91％（554个中的504个），EBUS-TBNA的合并诊断率为81％（704个中的567个）。比值比（OR）为2.5[95％置信区间（CI）：1.6至3.91；P<0.001]，I2为20%。良性疾病的亚组分析显示诊断率增加，OR为7.95（91％MedCryoBx对58％EBUS-TBNA，P<0.001)，I2为25%。淋巴瘤的亚组分析显示，合并诊断率有统计学显着增加，OR为11.48（87％MedCryoBx对29％EBUS-TBNA，P=0.001)。最常见的并发症是轻度出血（36.5％），没有任何干预。患者出现需要干预的出血（0.7%）。气胸（0.4%）和纵隔气肿（0.4%）在本分析中并不常见。
■MedCryoBx是诊断胸内腺病的一个非常有前途的工具。在良性和可能的淋巴增生性疾病中，它比EBUS-TBNA提高了诊断率。但在肺癌中更少。MedCryoBx的并发症发生率与EBUS-TBNA相当。
■我们使用GoogleScholar进行了系统的搜索，Embase,和PubMed/MEDLINE用于使用MedCryoBx和EBUS-TBNA诊断胸内腺病的研究。两位作者使用质量评估数据抽象和合成-2（QUADAS-2）工具分别审查了固有偏倚的研究。随机效应的逆方差加权方法用于荟萃分析。估计了总体和亚组的汇总诊断率。对MedCryoBx的并发症进行了回顾。
■对844例患者进行活检的10项研究进行了最终分析。共有554名患者接受了MedCryoBx和704名患者接受了EBUS-TBNA。荟萃分析显示，MedCryoBx的合并诊断率为91％（554个中的504个），EBUS-TBNA的合并诊断率为81％（704个中的567个）。比值比（OR）为2.5[95％置信区间（CI）：1.6至3.91；P<0.001]，I2为20%。良性疾病的亚组分析显示诊断率增加，OR为7.95（91％MedCryoBx对58％EBUS-TBNA，P<0.001)，I2为25%。淋巴瘤的亚组分析显示，合并诊断率有统计学显着增加，OR为11.48（87％MedCryoBx对29％EBUS-TBNA，P=0.001)。最常见的并发症是轻度出血（36.5％），没有任何干预。患者出现需要干预的出血（0.7%）。气胸（0.4%）和纵隔气肿（0.4%）在本分析中并不常见。
■MedCryoBx是诊断胸内腺病的一个非常有前途的工具。在良性和可能的淋巴增生性疾病中，它比EBUS-TBNA提高了诊断率。但在肺癌中更少。MedCryoBx的并发症发生率与EBUS-TBNA相当。
