Evidence map›Paper›PMID 42045698›Full record

SynthesisLung2026

Diagnostic Performance and Safety of Endobronchial Ultrasound-Guided Sampling for Mediastinal/Hilar Lymphadenopathy: A Systematic Review and Network Meta-analysis.

Shuping Lyu, Ziwen Zheng, Junwei Guo, Xiaoya Yu, Xiaoguo Feng, Mingming Deng, Venerino Poletti, Gang Hou

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Lung, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shuping Lyu *National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China.
Ziwen Zheng *National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China.
Junwei Guo *National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China.
Xiaoya YuCapital Medical University, Beijing, People's Republic of China.
Xiaoguo FengNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China.
Mingming DengNational Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China.
Venerino Poletti *Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
Gang Hou *National Center for Respiratory Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, 2nd Yinghuadong Street, Beijing, People's Republic of China. hougangcmu@163.com.

Funding

Noncommunicable Chronic Diseases-National Science and Technology Major Project 2024ZD0528900
6 · The paper itself

Abstract

introductionMediastinal and/or hilar lymphadenopathy (MHL) has become more frequently identified. Despite advances in endobronchial ultrasound (EBUS)-guided sampling, evidence on the optimal modality is lacking. This systematic review and network meta-analysis aimed to compare the diagnostic performance and safety of different EBUS-guided sampling methods in MHL.

methodsThis study was performed on published studies reporting the diagnostic performance and complications of EBUS-guided transbronchial needle aspiration (EBUS-TBNA), EBUS-guided transbronchial mediastinal cryobiopsy (EBUS-TBMC), EBUS-guided transbronchial forceps biopsy (EBUS-TBFB) to sample MHL. The outcomes included the diagnostic yield, diagnostic sensitivity, negative predictive value and complications. A frequentist random-effects model was employed to rank the diagnostic performance and safety for network meta-analysis. Subgroup analysis was performed with stratification by disease.

resultsTwenty-two studies with 2357 patients were included. EBUS-TBMC had the highest diagnostic yield, at 88.0%, surpassing EBUS-TBFB (77.1%) and EBUS-TBNA (67.7%). For lymphoma, EBUS-TBMC achieved a diagnostic sensitivity of 94.1%, substantially higher than EBUS-TBNA (40.8%). For benign conditions, EBUS-TBMC (87.9%) also outperformed EBUS-TBNA (55.2%). In the network meta-analysis, the combination of EBUS-TBMC with EBUS-TBNA was the most effective approach and was significantly better than EBUS-TBNA alone. EBUS-TBMC was the best single method for diagnosing sarcoidosis. EBUS sampling can be considered acceptably safe, with the vast majority of complications being grade 1-2 bleeding.

conclusionEBUS-TBNA remains the established standard for diagnosing lung cancer among patients with MHL. EBUS-TBMC demonstrates superior overall performance, particularly in the diagnosis of benign entities and rare carcinomas. EBUS-TBFB plays a supplementary role. All of the techniques exhibit an acceptable safety profile.

Indexed as

BronchoscopyEndoscopic Ultrasound-Guided Fine Needle AspirationLymphadenopathyLymph NodesEndosonographyHumansLymphomaMediastinumPredictive Value of TestsCryobiopsyDiagnostic performanceEndobronchial ultrasound-guidedMediastinal/hilar lymphadenopathySafety

Identifiers

PMID42045698

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.