European Respiratory Review最新文献

{"title":"The importance of symptoms in bronchiectasis.","authors":"Alessandro De Angelis, Pau Marrades, Lidia Perea, Rosa Faner, Alessandra Iorfida, Stefano Aliberti, James D Chalmers, Oriol Sibila","doi":"10.1183/16000617.0085-2026","DOIUrl":"10.1183/16000617.0085-2026","url":null,"abstract":"<p><p>Bronchiectasis is a chronic respiratory disease characterised by irreversible bronchial dilatation, persistent airway inflammation and recurrent infections. Symptoms, particularly cough, sputum production and dyspnoea, are the most immediate and patient-relevant expression of the disease, linking clinical presentation, airway biology and outcomes. While asthma and COPD management algorithms already integrate symptom burden into therapeutic decision-making, bronchiectasis care has historically relied on exacerbation history to guide preventive interventions. Over the past decade, an expanding body of evidence has demonstrated that daily symptoms mirror current infection and inflammation, profoundly impact quality of life, and predict future exacerbations. Comparative analyses across chronic lung diseases further highlight the central role of symptom monitoring in defining disease activity and risk. The updated European Respiratory Society guidelines translate this evidence into clinical practice, marking a paradigm shift from an exacerbation-driven to a symptom-centred and treatable-traits model. This review synthesises clinical, biological and therapeutic insights linking symptoms to bronchiectasis pathophysiology, disease activity and treatment response. We discuss how airway clearance, mucoactive therapy, antibiotics, pulmonary rehabilitation and targeted anti-inflammatory strategies, including dipeptidyl peptidase-1 inhibition, can address specific symptom profiles. We also mention the role of comorbidities and psychosocial management, establishing symptoms as the cornerstone of a holistic, multidimensional care approach. Recognising symptoms as both biomarkers of activity and therapeutic targets represents a major step toward precision medicine in bronchiectasis, aligning clinical management with patient experience and the biological drivers of disease.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mucoactive agents in bronchiectasis: a systematic review and meta-analysis.","authors":"Benjamin McCullough, John Busby, Brenda O'Neill, Bronwen Connolly, Rebecca H McLeese, Dermot Linden, Daniel F McAuley, J Stuart Elborn, Anthony De Soyza, James D Chalmers, Mike Clarke, Judy M Bradley","doi":"10.1183/16000617.0014-2026","DOIUrl":"10.1183/16000617.0014-2026","url":null,"abstract":"<p><strong>Background: </strong>Mucoactive agents aim to improve mucociliary clearance in bronchiectasis, disrupting the cycle of impaired clearance, infection and inflammation. Registry data show 28% of patients use these agents, but prescribing varies due to limited evidence. We aimed to update evidence on mucoactive agents' effects in adults with bronchiectasis.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis, searching Medline, Embase, CENTRAL and trial registries to 1 October 2025. Eligible studies included adults with bronchiectasis, evaluating any mucoactive agent <i>versus</i> placebo or control. Cystic fibrosis and paediatric studies were excluded. The primary outcome was exacerbation frequency; secondary outcomes included lung function, quality of life and adverse events.</p><p><strong>Findings: </strong>From 1512 records, 24 studies (20 randomised, four observational: n=7051) evaluated eight mucoactive agents (ambroxol, bromhexine, carbocisteine, erdosteine, hypertonic saline, mannitol, N-acetylcysteine, rhDNase). Most trials had high or some risk of bias. Seven randomised studies (n=1259) reported exacerbations; pooled analysis did not demonstrate a statistically significant difference in annualised exacerbation incidence (mean difference -0.40 per patient per year, 95% CI -1.04-0.24; p=0.22; I²=91%; very low certainty). Nine studies (n=767) reported percent predicted forced expiratory volume in 1 s (FEV₁ % pred), showing a small mean increase of 3.23% (95% CI 0.31-6.15; p=0.03; I²=69.9%; very low certainty). Pooled analyses did not demonstrate significant differences for other spirometry measures, quality of life or adverse events.</p><p><strong>Interpretation: </strong>Pooled evidence did not show a reduction in exacerbations and FEV₁ % pred improvements were small. Evidence certainty was low/very low, meaning overall clinical benefit remains uncertain, highlighting the need for targeted trials of specific agents and subgroups.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global disparities in chronic dyspnoea prevalence in population-based studies: a comprehensive literature review.","authors":"Solène Valery, Nicolas Roche, Thierry Perez, Rachel Nadif","doi":"10.1183/16000617.0245-2025","DOIUrl":"10.1183/16000617.0245-2025","url":null,"abstract":"<p><strong>Background: </strong>Chronic dyspnoea is a common and disabling symptom that remains under-investigated as an independent entity at a population level. Most research has focused on dyspnoea as a feature of specific diseases, mainly in high-income countries.</p><p><strong>Objective: </strong>We aimed to assess the global prevalence of chronic dyspnoea in population-based studies, and discuss disparities across regions and populations, including low- and middle-income countries.</p><p><strong>Methods: </strong>PubMed, the Cumulative Index to Nursing and Allied Health Literature, Google Scholar and Embase were searched using dedicated algorithms. The literature up to 2 September 2025 was reviewed; studies reporting chronic dyspnoea prevalence in general populations were included, and those restricted to older adults or specific subgroups were excluded.</p><p><strong>Results: </strong>68 studies met the inclusion criteria. Although limited in scope, the modified Medical Research Council scale was the most frequently used tool. Prevalence varied widely, from 5-10% in Europe to >25% in South Asia. Differences were observed between high- and low-income countries, between low-income countries, and within the same country over time. Observed disparities stem from variations in definitions, assessment methods, socioeconomic conditions, possible genetic predispositions, environmental exposures, and lifestyle factors. Chronic dyspnoea has been associated with demographic, behavioural and health-related factors including sex, age, weight, physical activity and comorbidities.</p><p><strong>Conclusion: </strong>There are major global disparities in the prevalence of chronic dyspnoea between and within countries at different income levels. There is a critical need for targeted, country-specific studies, particularly in low- and middle-income countries, to support equitable interventions, and for newly designed studies using more detailed and comprehensive measures of dyspnoea.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The upper airway in obstructive sleep apnoea: state of the art.","authors":"Johan Verbraecken, Sara Op de Beeck, Alan R Schwartz, Olivier M Vanderveken","doi":"10.1183/16000617.0005-2026","DOIUrl":"10.1183/16000617.0005-2026","url":null,"abstract":"<p><p>The upper airway is a complex structure, prone to repetitive collapse in obstructive sleep apnoea (OSA). This review discusses the pathophysiological aspects of OSA, with a focus on the anatomy and pathophysiology of upper airway obstruction. This disorder is characterised by different mechanisms that constitute its pathology, which may all contribute to apnoea presence and severity. These include pharyngeal anatomy, collapsibility, upper airway muscle responsiveness, loop gain and arousal threshold. Identification of interindividual differences in the underlying mechanisms of OSA offers promise for a more targeted approach to OSA management.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WABIP/AABIP statement on therapeutic indications of medical thoracoscopy for benign pleural disease.","authors":"Udit Chaddha, Abhinav Agrawal, Uzair Ghori, Bertin D Salguero, Nick A Maskell, Kazuhiro Yasufuku, Samira Shojaee, Labib Gilles Debiane, Horiana B Grosu, Takahiro Nakajima, Thitiwat Sriprasart, Rajesh Thomas, Ales Rozman, Phillippe Astoul, Adnan Majid, Kiyoshi Shibuya, Carla Lamb, Pyng Lee","doi":"10.1183/16000617.0327-2025","DOIUrl":"10.1183/16000617.0327-2025","url":null,"abstract":"<p><p>Medical thoracoscopy (MT) is a minimally invasive procedure with a well-established role in the diagnosis and management of malignant pleural disease; however, its therapeutic applications in benign pleural conditions remain variably adopted and inconsistently defined. In response to increasing clinical utilisation and emerging evidence, the World Association for Bronchology and Interventional Pulmonology (WABIP) and the American Association for Bronchology and Interventional Pulmonology (AABIP) convened a multidisciplinary, international expert panel to develop a consensus statement examining the therapeutic role of MT in benign pleural disease. Six clinically relevant PICO (patient, intervention, comparison and outcome) questions were formulated to guide a systematic literature review of PubMed, Scopus and Cochrane databases from 1980 through 2025. Evidence was appraised using standardised risk-of-bias tools and consensus was achieved using a modified Delphi methodology. This consensus statement summarises the available evidence regarding MT across a spectrum of benign pleural conditions, including recurrent benign pleural effusions, primary and secondary spontaneous pneumothorax, empyema, and tuberculous pleural disease. Emphasis is placed on procedural outcomes, complication profiles and comparative effectiveness relative to alternative medical and surgical approaches. The document also highlights key considerations related to patient selection, procedural complexity and the influence of operator expertise and local resources on clinical outcomes. Given the heterogeneity of underlying disease processes and the predominance of observational data, this work is presented as a consensus statement rather than a formal clinical practice guideline. Overall, it aims to consolidate current knowledge, identify gaps in evidence and provide a practical framework to inform multidisciplinary decision-making and future research on the therapeutic use of MT in benign pleural disease.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148316395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in sleep diagnostics for children under 2 years of age: state of the evidence and future directions.","authors":"Molla Imaduddin Ahmed, Jessica Taytard, Stijn Verhulst, Iulia Ioan","doi":"10.1183/16000617.0335-2025","DOIUrl":"10.1183/16000617.0335-2025","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has advanced rapidly in adult sleep medicine, but its role in children under 2 years old remains unclear. This scoping review maps the current evidence on AI-enabled diagnostics in neonates, infants and toddlers, identifying challenges, opportunities and research priorities.</p><p><strong>Methods: </strong>A structured scoping review was undertaken up to April 2025, incorporating peer-reviewed studies, normative datasets, regulatory reports and evidence on consumer and commercial technologies. Studies focusing on children under 2 years were prioritised, with older cohorts reviewed where relevant to translation.</p><p><strong>Findings: </strong>No AI tool is validated for independent diagnostic use in this age group. Research prototypes, including automated polysomnography scoring, convolutional neural networks for oximetry and multimodal wearable or radar-based systems, show feasibility but remain experimental. Commercial platforms such as SleepImage, Belun Sleep Health and WatchPAT exclude children under 2 years, while consumer monitors including Owlet, Nanit and Miku are widely used but lack clinical validation.</p><p><strong>Conclusion: </strong>AI in sleep diagnostics for children under 2 years remains an emerging field with high potential but no current clinical readiness. Progress will depend on the development of infant-specific datasets, improved artefact handling, simplified monitoring strategies and human-in-the-loop workflows. Longer-term opportunities include prognostic modelling, circadian analysis and predictive closed-loop systems, but equity and regulatory clarity must guide translation to ensure safe and globally relevant impact.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic performance and safety of image-guided pleural biopsy and medical thoracoscopy for undiagnosed exudative pleural effusion: a systematic review and network meta-analysis.","authors":"Shuping Lyu, Ziwen Zheng, Liwei Liao, Xiaoguo Feng, Mingming Deng, Jia Li, José M Porcel, Gang Hou","doi":"10.1183/16000617.0310-2025","DOIUrl":"10.1183/16000617.0310-2025","url":null,"abstract":"<p><strong>Introduction: </strong>Undiagnosed exudative pleural effusions often require pleural biopsy for a definitive diagnosis. The optimal sampling method, particularly when medical thoracoscopy is compared with image-guided pleural biopsy, remains uncertain.</p><p><strong>Methods: </strong>This systematic review and network meta-analysis included studies that reported on the diagnostic performance and safety of medical thoracoscopy and image-guided pleural biopsy approaches. The primary outcome of this study was diagnostic yield, and the secondary outcomes included other diagnostic parameters (<i>e.g.</i> sensitivity, negative likelihood ratio, and negative predictive value), post-procedure complications, and biopsy quality and number. A frequentist network meta-analysis was performed to compare and rank the diagnostic performance and safety of various pleural biopsy methods using a random-effects model. A subgroup analysis was performed according to the presence of pleural nodules or thickness and the type of biopsy needles used.</p><p><strong>Results: </strong>An analysis of 64 studies involving 8744 patients revealed that rigid medical thoracoscopy had the highest diagnostic yield (95.0%), followed by cryobiopsy (93.1%), semirigid medical thoracoscopy (92.3%), and ultrasound elastography (UE)-guided biopsy (92.3%). Closed pleural biopsy had the lowest yield (75.1%). The current evidence is insufficient to establish the superiority of any biopsy method in terms of complications<i>.</i> The network meta-analysis ranked rigid medical thoracoscopy as having the highest overall diagnostic yield, closely followed by UE-guided biopsy, with no statistically significant differences between image-guided biopsy and rigid medical thoracoscopy.</p><p><strong>Conclusion: </strong>Closed pleural biopsy consistently has a low diagnostic yield and is not recommended as a first-line biopsy method for patients with undiagnosed exudative pleural effusions. Rigid medical thoracoscopy offers distinct clinical value for a complete visual inspection, large biopsies, and potential pleurodesis, particularly in suspected mesothelioma cases. The currently available evidence does not support the routine replacement of semirigid medical thoracoscopy with cryobiopsy. Computed tomography-guided biopsy may be preferred in cases involving thickening ≥10 mm or small target lesions. Conversely, ultrasound-guided biopsy may be appropriate for lesions measuring ≥3 mm with a clear acoustic window. UE-guided pleural biopsy shows promise as an emerging option, although the evidence is limited. In tuberculous pleurisy, medical thoracoscopy may offer higher diagnostic sensitivity in certain settings, particularly in high-prevalence areas. The current evidence is insufficient to establish a clear advantage for any biopsy method regarding the overall complication risk.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory impacts of earthquakes.","authors":"Ozlem Kar Kurt, Ozgecan Kayalar, Abdullah Burak Yildiz, Zahra Shahpar, Isabella Annesi-Maesano, Hasan Bayram","doi":"10.1183/16000617.0257-2025","DOIUrl":"10.1183/16000617.0257-2025","url":null,"abstract":"<p><p>Millions of people worldwide live in areas prone to earthquakes and face devastating consequences and severe medical issues. Earthquakes not only cause massive destruction but also release hazardous mixtures of dust, fibres, microbes and toxic particles from collapsed structures, posing serious risks to the respiratory system and other organs. Survivors, search and rescue workers and volunteers can be heavily exposed to earthquake-related hazards. The respiratory health impacts of earthquake-related exposures include both acute and long-term effects, as well as exacerbation of chronic pulmonary diseases. This narrative review focuses on the spectrum of environmental and occupational exposures that arise after earthquakes and their associated short- and long-term respiratory consequences. By incorporating post-earthquake particulate matter measurements of 2.5 and 10 µm diameter from the 2023 Türkiye-Syria earthquakes (also referred to as the Kahramanmaraş earthquakes), the review highlights exposure patterns that remain underrepresented in the existing literature. Furthermore, it places these findings within an earthquake-specific public health framework, aiming to inform risk reduction, preparedness and mitigation strategies relevant to affected communities.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Palliative care interventions for thoracic cancer: a systematic review and meta-analysis identifying the core elements.","authors":"Anne M Walker, Donald R Sullivan, Anne E Holland, Phan Nguyen, Sarah Yeo, Amy Pascoe, Lorena Romero, Natasha Smallwood","doi":"10.1183/16000617.0247-2025","DOIUrl":"10.1183/16000617.0247-2025","url":null,"abstract":"<p><strong>Introduction: </strong>Despite increasing trials examining palliative care for people with thoracic cancer, implementation remains limited. Understanding the core elements of palliative care interventions is critical to improving design, scalability, and accessibility globally. This review aimed to determine the core elements and efficacy of palliative care interventions in thoracic cancer.</p><p><strong>Methods: </strong>Five medical databases were searched from January 1987 to January 2025. Randomised controlled trials (RCTs) and nonrandomised studies of palliative care interventions in thoracic cancer addressing at least two National Consensus Project domains were eligible. Meta-analyses of RCTs were performed using a random-effects model.</p><p><strong>Results: </strong>34 palliative care interventions (n=6490, mean±sd age 65±10 years, 41% women) were identified. Interventions were categorised as comprehensive palliative care interventions (n=18), nonpharmacological symptom interventions (n=12) and psychosocial-educational interventions (n=4). Comprehensive interventions were significantly longer (21.7 weeks) than nonpharmacological symptom (4.8 weeks) and psychosocial-educational interventions (8.7 weeks; p<0.01), addressed more components (mean components: 8, 3, 4, respectively; p<0.01), were often provided by specialist palliative care clinicians (83%, 16%, 0%; p<0.01), and included interprofessional teams (61%, 8%, 0%; p<0.01). Comprehensive palliative care interventions improved quality of life (standardised mean difference (SMD) 0.25, 95% CI 0.11-0.38), survival (hazard ratio 0.76, 95% CI 0.62-0.94), overall symptoms (SMD 0.20, 95% CI 0.02-0.38) and depression (SMD 0.28, 95% CI 0.07-0.5). Nonpharmacological symptom interventions improved breathlessness (SMD 0.29, 95% CI 0.15-0.43) and depression (SMD 0.17, 95% CI 0.02-0.31). Psychosocial-educational interventions did not affect quality of life or mood.</p><p><strong>Conclusions: </strong>Comprehensive palliative care interventions improved quality of life, survival and symptoms among people with thoracic cancers. Nonpharmacological symptom interventions improved breathlessness and depression.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transbronchial needle core biopsy <i>versus</i> aspiration under endobronchial ultrasound guidance: a meta-analysis.","authors":"Sheng-Ping Li, Shang-Zhi Hu, Yan Luo","doi":"10.1183/16000617.0001-2026","DOIUrl":"10.1183/16000617.0001-2026","url":null,"abstract":"<p><strong>Background: </strong>Endobronchial ultrasound-guided transbronchial needle core biopsy (EBUS-TBNB) is an emerging technique designed to obtain histological specimens from mediastinal lesions. This meta-analysis aims to compare the performance of EBUS-TBNB <i>versus</i> endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal disorders.</p><p><strong>Methods: </strong>A thorough search of the literature was performed across PubMed, Embase and Web of Science databases, covering the period from their inception through 1 October 2025. Diagnostic yields were pooled <i>via</i> inverse variance weighting using fixed- or random-effects models based on heterogeneity. Complications were carefully assessed and categorised.</p><p><strong>Results: </strong>11 studies involving 1434 patients were analysed. The pooled diagnostic yield was 88.51% (678/766) for EBUS-TBNB and 80.11% (741/925) for EBUS-TBNA, with an odds ratio of 2.04 (95% CI 1.52-2.74; p<0.00001) and I²=23%. Subgroup analysis showed significantly higher yield with EBUS-TBNB for lymphoma (OR 5.22, 95% CI 1.12-24.26; p=0.04) and sarcoidosis (OR 2.88, 95% CI 1.64-5.04; p=0.0002), while no significant difference was observed for lung cancer (OR 1.18, 95% CI 0.77-1.81; p=0.45). The safety profiles of EBUS-TBNB and EBUS-TBNA were favourable, with low complication rates and no procedure-related mortality.</p><p><strong>Conclusion: </strong>Current pooled evidence suggests a possible diagnostic advantage of EBUS-TBNB over EBUS-TBNA, particularly for lymphoma and sarcoidosis, with a similar safety profile. However, this apparent benefit should be interpreted cautiously given the limited randomised evidence, heterogeneity across needle platforms and substantial contribution of observational studies.</p>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"35 180","pages":""},"PeriodicalIF":10.8,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13250676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}