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Endoscopic ultrasound:It’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

查看全文 作　　者：Srinivas R [1]Puli;Jyotsna Batapati Krishna [1]Reddy;Matthew L [1]Bechtold;Jamal A [1]Ibdah;Daphne [1]Antillon;Shailender [2]Singh;Mojtaba [2]Olyaee;Mainor R [1]Antillon 高影响力作者 机构地区：[1]Division of Gastroenterology and Hepatology,University of Missouri- Columbia;[2]Division of Gastroenterology and Hepatology,University of Kansas School of Medicine高影响力机构 出　　处：《World Journal of Gastroenterology》索引2008年第14卷第19期,共10页高影响力期刊 摘　　要：AIM:To evaluate the accuracy of endoscopic ultrasound (EUS), EUS-fine needle aspiration (FNA) in evaluating mediastinal lymphadenopathy. METHODS:Only EUS and EUS-FNA studies confirmed by surgery or with appropriate follow-up were selected. Articles were searched in Medline, Pubmed, and Cochrane control trial registry. Only studies from which a 2 × 2 table could be constructed for true positive, false negative, false positive and true negative values were included. Two reviewers independently searched and extracted data. The differences were resolved by mutual agreement. Meta-analysis for the accuracy of EUS was analyzed by calculating pooled estimates of sensitivity, specificity, likelihood ratios, and diagnostic odds ratios. Pooling was conducted by both Mantel-Haenszel method (fixed effects model) and DerSimonian Laird method (random effects model). The heterogeneity of studies was tested using Cochran’s Q test based upon inverse variance weights. RESULTS:Data was extracted from 76 studies (n = 9310) which met the inclusion criteria. Of these, 44 studies used EUS alone and 32 studies used EUS-FNA. FNA improved the sensitivity of EUS from 84.7% (95% CI:82.9-86.4) to 88.0% (95% CI:85.8-90.0). With FNA, the specificity of EUS improved from 84.6% (95% CI:83.2-85.9) to 96.4% (95% CI:95.3-97.4). The P forchi-squared heterogeneity for all the pooled accuracy estimates was > 0.10. CONCLUSION:EUS is highly sensitive and specific for the evaluation of mediastinal lymphadenopathy and FNA substantially improves this. EUS with FNA should be the diagnostic test of choice for evaluating mediastinal lymphadenopathy. 关 键 词：内窥镜检查法 淋巴结病 检查方法 诊断方法
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