Abstract
Objective: The aim of the study was to assess the diagnostic yield of the real-time endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the diagnosis and staging of lung cancer.
Patients and methods: 134 patients with suspected lung cancer with mediastinal and/or hilar lymph nodes underwent EBUS-TBNA using the convex probe EBUS. All patients with negative EBUS-TBNA subsequently underwent the surgery or mediastinoscopy as a confirmatory test.
Results: One hundred thirty four patients underwent CP-EBUS-TBNA between December 2007 to December 2009. There were 233 mediastinal & hilar lymph nodes biopsied (stations: 2R-3,4R-73, 4L-21, 7-65, 10R-23, 10L-5, 11R-26, 11L-17). EBUS-TBNA revealed metastatic lymph node involvement in 54 of 134 patients (40.3%) and in 56 of 233 biopsies (24%). In 80 patients with negative or uncertain EBUS-TBNA who underwent subsequent surgery, mediastinoscopy, metastatic nodes were diagnosed in four patients (3%) in stations: (4R-2,4L-1 & 7-1). The false-negative results of biopsies were found only in small nodes <1cm. A diagnostic sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of EBUS-TBNA was 93.1%, 100%, 100%, 94.5%,and 96.9%, respectively.there was no significant relation between lymph node location and EBUS-TBNA cytology results. No complications of EBUS-TBNA were observed.
Conclusion: EBUS-TBNA is an effective and safe technique for diagnosis & mediastinal staging in patients with lung cancer. In patients with negative results of EBUS-TBNA, surgical exploration of the mediastinum should be performed.
- © 2011 ERS