Computed tomography-guided lung biopsy for molecular tests: a meta-analysis

Introduction
Computed tomography (CT)-guided lung biopsy has been widely used for molecular testing.

Aim
To evaluate the potential clinical effectiveness of computed tomography (CT)-guided lung biopsy in molecular tests.

Material and methods
We searched the related studies from the PubMed, Embase, and Cochrane Library until July 2021. The endpoints included adequacy rates for molecular tests, positive rates of epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) translocation, and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations.

Results
Initially, we were able to identify 1783 potentially relevant studies, among which only 12 were ultimately included in the present meta-analysis. All the studies were retrospective in nature. A total of 2559 patients underwent CT-guided lung biopsy and 1414 of them received molecular testing. We found that the pooled adequacy rate for molecular tests, positive rate of EGFR mutations, and positive rate of ALK translocation were 95%, 49%, and 7%, respectively. Significant heterogeneity was detected in the endpoints of adequacy rate for molecular tests (I2 = 86.2%) and positive rate of EGFR mutations (I2 = 77.7%). We did not identify any variables that could significantly influence the adequacy rate for molecular tests and positive rate of EGFR mutations. A high risk of publication bias was also found in the endpoint of adequacy rate for molecular tests.

Conclusions
CT-guided lung biopsy can serve as an effective method to provide sufficient lung cancer samples for molecular testing. The EGFR gene was found to be the most frequently mutated during the analysis.