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Review
. 2017 Jul;72(7):438-448.
doi: 10.6061/clinics/2017(07)09.

The diagnostic value of narrow-band imaging for early and invasive lung cancer: a meta-analysis

Juanjuan Zhu  1   2 , Wei Li  1   2 , Jihong Zhou  3 , Yuqing Chen  1   2 , Chenling Zhao  1   2 , Ting Zhang  4 , Wenjia Peng  5 , Xiaojing Wang  1   2
Affiliations
Review

The diagnostic value of narrow-band imaging for early and invasive lung cancer: a meta-analysis

Juanjuan Zhu et al. Clinics (Sao Paulo). 2017 Jul.

Abstract

This study aimed to compare the ability of narrow-band imaging to detect early and invasive lung cancer with that of conventional pathological analysis and white-light bronchoscopy. We searched the PubMed, EMBASE, Sinomed, and China National Knowledge Infrastructure databases for relevant studies. Meta-disc software was used to perform data analysis, meta-regression analysis, sensitivity analysis, and heterogeneity testing, and STATA software was used to determine if publication bias was present, as well as to calculate the relative risks for the sensitivity and specificity of narrow-band imaging vs those of white-light bronchoscopy for the detection of early and invasive lung cancer. A random-effects model was used to assess the diagnostic efficacy of the above modalities in cases in which a high degree of between-study heterogeneity was noted with respect to their diagnostic efficacies. The database search identified six studies including 578 patients. The pooled sensitivity and specificity of narrow-band imaging were 86% (95% confidence interval: 83-88%) and 81% (95% confidence interval: 77-84%), respectively, and the pooled sensitivity and specificity of white-light bronchoscopy were 70% (95% confidence interval: 66-74%) and 66% (95% confidence interval: 62-70%), respectively. The pooled relative risks for the sensitivity and specificity of narrow-band imaging vs the sensitivity and specificity of white-light bronchoscopy for the detection of early and invasive lung cancer were 1.33 (95% confidence interval: 1.07-1.67) and 1.09 (95% confidence interval: 0.84-1.42), respectively, and sensitivity analysis showed that narrow-band imaging exhibited good diagnostic efficacy with respect to detecting early and invasive lung cancer and that the results of the study were stable. Narrow-band imaging was superior to white light bronchoscopy with respect to detecting early and invasive lung cancer; however, the specificities of the two modalities did not differ significantly.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Study flow diagram.
Figure 2
Figure 2
Six-study analysis of the ability of NBI to diagnose early lung cancer and invasive lung cancer. A. Pooled sensitivity of NBI for the diagnosis of early lung cancer and invasive lung cancer; B. Pooled specificity of NBI for the diagnosis of early lung cancer and invasive lung cancer; C. The summary receiver operating characteristic (SROC) curve for the diagnosis of early lung cancer and invasive lung cancer by NBI.
Figure 3
Figure 3
Four-study analysis of the ability of NBI to diagnose early lung cancer and invasive lung cancer. A. Pooled sensitivity of NBI for the diagnosis of early lung cancer and invasive lung cancer; B. Pooled specificity of NBI for the diagnosis of early lung cancer and invasive lung cancer; C. The SROC curve for the diagnosis of early lung cancer and invasive lung cancer by NBI.
Figure 4
Figure 4
Four-study analysis of the ability of WLB to diagnose early lung cancer and invasive lung cancer. A. Pooled sensitivity of WLB for the diagnosis of early lung cancer and invasive lung cancer; B. Pooled specificity of WLB for the diagnosis of early lung cancer and invasive lung cancer; C. The SROC curve for the diagnosis of early lung cancer and invasive lung cancer by WLB.
Figure 5
Figure 5
A. The pooled RR for the sensitivity of NBI vs the sensitivity of WLB for the detection of early lung cancer and invasive lung cancer; B. The pooled RR for the specificity of NBI vs the specificity of WLB for the detection of early lung cancer and invasive lung cancer.
Figure 6
Figure 6
Deeks funnel plot for the evaluation of publication bias.
See this image and copyright information in PMC

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