Pulmonary Procedures |

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration in the Diagnosis and Staging of Lung Cancer FREE TO VIEW

Hamdy Mahmoud, MD; Rex Yung, MD
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Sohag University-Sohag Faculty of Medicine, Sohag-Elmaragha-Nagecc Elhakim, Egypt

Chest. 2013;144(4_MeetingAbstracts):811A. doi:10.1378/chest.1703832
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SESSION TITLE: Bronchoscopy and Interventional Procedures Posters II

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: 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.

METHODS: This study involved134 consecutive 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. Final diagnosis was based on cytology, surgical results, and/or clinical follow-up.

RESULTS: A total of 134 patients were included in the study. 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 (5%) 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.No complications occurred from EBUS-TBNA . Mediastinoscopy was avoided in 86 patients. .

CONCLUSIONS: 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.

CLINICAL IMPLICATIONS: EBUS-TBNA is an effective and safe technique for diagnosis & mediastinal staging in patients with lung cancer. Thus need for supplementary standard cervical Mediastinoscopies & surgery for diagnosis & staging of lung cancer decreased significantly .

DISCLOSURE: The following authors have nothing to disclose: Hamdy Mahmoud, Rex Yung

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