Abstract
Aim: The aim of this study was to investigate the factors influencing to obtain material that does not reflect the lymph node(inadequate material).
Methods: Files of EBUS-TBNA performed patients between July 2013-November 2014 in our clinic were examined retrospectively.Demographic data of patients,the stations,short axis and morphological characteristics of EBUS-TBNA performed LNs,number of punctures from each LN and needle type used in EBUS-TBNA were recorded.The absence or limited number of lymphocytes in the smear (with 40xmagnification,<40 lymphocytes) were used as criteria of non-diagnostic material.Mann-Whitney U,Chi-square,and logistic regression analysis were used on the determination of risk factors for inadequate material.p value <0.05 was considered significant.
Results: 331 patients included in the study.A total of 1655 punctures(2.56±0.74/LN) were performed from 644 LNs in 331 patients.The average short axis of LNs was 1.75±1.05 cm.There was no statistically significant relationship between age and gender of the patients,short diameter,echogenicity and edge features of the LNs with obtaining inadequate material.The number of LN puncteres were 307 and 337 with M(Medi-GlobeGmbH) type and O(Olympus) type needles respectively and the ratio of obtaining inadequate material with them were were 15.3% and 13.1% respectively(p> 0.05).However a highly significant inverse relation between obtaining inadequate material with puncture number for each LN was revealed(p <0.0001).The ratio of obtaining inadequate material with 1,2,3, and ≥4 punctures were 31.3%,17.9%,11.2%, and 0, respectively.
Conclusion: Three or more puncture from each LN should be performed in order to increase the diagnostic value of EBUS-TBNA.
- Copyright ©ERS 2015