Accuracy of nanopore sequencing technology for rapid diagnosis of tuberculous mediastinal and hilar lymphadenopathy using endobronchial ultrasound-guided transbronchial needle aspiration specimens: protocol for a systematic review and meta-analysis

Introduction Accessing samples from mediastinal and hilar lymph nodes is considerably more difficult, rendering the diagnosis of tuberculous mediastinal and hilar lymphadenopathy particularly challenging. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive interventional technique used for sampling mediastinal and hilar lymph nodes.

Nanopore sequencing technology (NST) permits the rapid identification of Mycobacterium tuberculosis genes directly from clinical samples. NST has significantly improved the diagnostic accuracy for both pulmonary and extrapulmonary tuberculosis; its accuracy in diagnosing tuberculous mediastinal and hilar lymphadenopathy using EBUS-TBNA specimens has not yet been systematically evaluated.

Methods and analysis Adhering to Preferred Reporting Items for a Systematic Review and Meta-Analysis Protocols (PRISMA-P) and PRISMA-Diagnostic Test Accuracy Studies (DTA) guidelines, this protocol (PROSPERO: CRD420251274529) will synthesise evidence from five international databases (PubMed, Embase, SCOPUS, Web of Science and Cochrane Library) and two Chinese databases (China National Knowledge Infrastructure and Wanfang Database). The literature search is planned to be conducted between 1 December 2026 and 31 December 2026 (start and end dates of the search).