Test Performance of Combined Endobronchial and Endoesophageal Ultrasound-Guided Fine-Needle Aspiration for Mediastinal Staging of Lung Cancer: A Meta-Analysis

Objective Owing to the complementary reach of endobronchial ultrasound-guided transbronchial needle aspiration （EBUS-TBNA） and transoesophageal ultrasound-guided fine-needle aspiration （EUS-FNA） in assessing different regions of the mediastinum, it suggested that complete and accurate mediastinal staging may be achieved by the combination of both procedures. A systematic review was performed of published studies evaluating combined EBUS-TBNA and EUS-FNA for mediastinal lymph node staging to ascertain the pooled sensitivity and specificity of this investigation. Methods MEDLINE were searched for studies evaluating combined EBUS-TBNA and EUS-FNA accuracy in mediastinal staging with no language restriction. Meta-DiSc software was used to calculate pool sensitivity and specificity. Results Six studies met inclusion criteria and had data suitable for extraction and analysis. Using a fixed effects model, the pooled sensitivity and specificity were 0.90（95%CI 0.86~0.94）, 0.99（95%CI 0.98~1.00）, respectively. Conclusions Combined EBUS-TBNA and EUS-FNA has excellent overall sensitivity and specificity for mediastinal lymph node staging in patients with lung cancer.