A systematic review and meta-analysis of the adequacy of endobronchial ultrasound transbronchial needle aspiration for next-generation sequencing in patients with non-small cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Netherlands), 2022-04, Vol.166, p.17-26
• Main Authors: Zhao, Joseph J, Chan, Hiang Ping, Soon, Yu Yang, Huang, Yiqing, Soo, Ross A, Kee, Adrian C L
• Format: Article
• Language: English
• Subjects: Bronchoscopy; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - genetics; Endobronchial ultrasound transbronchial needle aspiration; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; High-Throughput Nucleotide Sequencing; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - genetics; Next-generation sequencing
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2022.01.018

•Endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) offers a potential route to routinely obtain specimens for Next-Generation Sequencing (NGS) analysis.•In this meta-analysis of 21 studies comprising 1,175 patients, EBUS-TBNA demonstrates a high yield (∼80.9 to 91.4%) for NGS, reaffirming the suitability of utilizing EBUS-TBNA to retrieve specimens for NGS. Next-generation sequencing (NGS) is able to identify targetable mutations to guide therapy and endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) offers a potential route to routinely obtain specimens for analysis. However, the suitability of EBUS-TBNA samples for NGS remains uncertain. A search was conducted from inception till 28th August 2020. Pooled proportion of adequate EBUS-TBNA samples for NGS was obtained based on binomial distribution with Freeman-Tukey double-arcsine transformation. meta-analysis of means was conducted to determine mean weight of DNA extracted from EBUS-TBNA samples. meta-regression was performed to explore sources of heterogeneity. The random-effects model was used for all analyses to account for variation between studies. Twenty-one studies comprising 1,175 patients were included. The pooled proportion of adequate EBUS-TBNA samples for NGS (yield) was 86.5% (95%-CI: 80.9% to 91.4%). Pooled mean weight of DNA extracted from EBUS-TBNA samples was 868.7 ng (95%-CI: 446.3 ng to 1291.1 ng). However, considerable heterogeneity (I2 = 84.0%, 97.1%) was found. Meta-regression with a mixed-effects negative exponential model showed an increased proportion of adequate EBUS-TBNA samples for NGS as mean number of passes increases (β = 0.495, 95%-CI 0.313 to 0.676, P