ABSTRACT
OBJECTIVE: This meta-analysis is to determine the overall diagnostic yield of CT-guided transthoracic needle biopsy (TNB) of ground-glass opacity (GGO) lesions. METHODS: A PubMed search was performed using "ground-glass opacity" crossed with "core biopsy" and "needle biopsy". Test performance characteristics with the use of forest plots, summary receiver operating characteristic curves and bivariate random effects models were summarized. Adverse events, if reported, were recorded. RESULTS: Our search identified 52 citations, of which 6 diagnostic studies evaluated 341 patients. Pooled specificity estimates were 0.94 [95% confidence interval (CI), 0.84-0.98] and sensitivity estimates were 0.92 (95% CI, 0.88-0.95), respectively. The positive likelihood ratio was 11.27 (95% CI, 4.2-30.6), the negative likelihood ratio was 0.1 (95% CI, 0.06-0.19), the diagnostic odds ratio was 131.38 (95% CI, 39.6-436.0) and the area under the curve was 0.97. CONCLUSION: Our data suggest that the CT-guided TNB is likely to be a useful tool for tissue diagnosis and may serve as an alternative for further patient management with GGO lesions. However, considering the limited studies and patients included, large scale studies are needed to verify these findings. ADVANCES IN KNOWLEDGE: Some studies about CT-guided TNB of GGO lesions have been published, most have been small, single-institution case series. To our knowledge, our study is the first systematic analysis about CT-guided TNB of GGO lesions.
Subject(s)
Image-Guided Biopsy , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/pathology , Radiography, Interventional/methods , Tomography, X-Ray Computed/methods , Adult , Biopsy, Needle , Female , Humans , Lung/diagnostic imaging , Male , Middle Aged , ROC Curve , Sensitivity and SpecificityABSTRACT
The incorporation of fluorescently labeled dideoxynucleotides by T7 DNA polymerase is optimized by the use of Mn2+, fluorescein analogs and four 2'-deoxyribonucleoside 5'-O-(1-thiotriphosphates) (dNTP alpha S's). The one-tube extension protocol was tested on single-stranded templates, as well as PCR fragments which were made single-stranded by digestion with T7 gene 6 exonuclease. Dye primer sequencing using four dNTP alpha S's was shown to give uniform termination patterns which were comparable to four dNTPs. Efficiency of the polymerase also appeared to improve with the dNTP alpha S's. A mathematical model was developed to predict the pattern of termination based on enzyme activity and ratios of ddNTP/dNTPs. This method can be used to optimize sequencing reactions and to estimate enzyme discrimination constants of chain terminators.
