The Diagnostic Value of Endobronchial Ultrasound-guided Needle Aspiration Biopsy for Lung or Mediastinal Lymph Node Cancer and Tuberculosis

WANG Ye, ZHU Hui, YANG Sai. et al

Abstract

To determine the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosing lung or mediastinal lymph node cancer and tuberculosis. Methods Clinical and pathological data of 553 patients who underwent EBUS-TBNA from January 2013 to September 2016 in West China Hospital of Sichuan University were reviewed. The sensitivity, specificity and accuracy of EBUS-TBNA for diagnosing lymph node tumor and tuberculosis of hilar and mediastinal lymph nodes were calculated. Results The sensitivity, specificity and accuracy of EBUS-TBNA in diagnosing hilar and mediastinal lymph node cancer were 89.2% (263/295), 100% (247/247) and 94.1% (510/542), respectively, compared with 70% (76/117), 97.2% (385/396) and 89.9% (461/513), respectively, for diagnosing tuberculosis identified though granulomatous biopsy. In the 102 cases with acid fast staining and TB-PCR, 63.7% accuracy (58/91), 90.9% (10/11) sensitivity and 66.7% (68/102) specificity were found for any positive findings from acid fast bacilli or TB-DNA. Conclusion EBUS-TBNA has high sensitivity and specificity for diagnosing hilar and mediastinal tumor, which can be used in combination with acid fast staining and TB-PCR for diagnosing tuberculosis.

 

Keywords: Endobronchial ultrasound-guided needle aspiration biopsy, Lung or mediastinal, lymph nodes, Diagnosis 

 

Full Text:

PDF


References


NCCN Clinical Practice Guidelines in Oncology. Non-Small Cell Lung Cancer 2016 (v. 4. 2016). [2016-12-23]. https:// www. nccn. org/professionals/physician _ gls/f _ guidelines, asp.

HASSAN T, MCLAUGHLIN AM, O’CONNELL F. et al. EBUS-TBNA performs well in the diagnosis of isolated thoracic tuberculous lymphadenopathy. Am J Respir Crit Care Med.2011. 183( 1): 136-137.

YE T. HU H, LUO X, et al. The role of endobronchial ultrasound guided transbronchial needle aspiration ( EBUS- TBNA ) for qualitative diagnosis of mediastinal and hilar lymphadenopathy: a prospective analysis. BMC Cancer. 2011, 11; 100 [ 2016-11-30 ]. http; //bmccancer. biomed central, com/articles/10. 1186/1471-2407-11-100. doi: 10. 1186/1471-2407-11-100.

GU P. ZHAO YZ, JIANG LY, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer; a systematic review and meta-analysis. Eur J Cancer, 2009,4 5 (8): 1389-1396.

ADAMS K, SHAH PL, EDMONDS L, et al. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer; systematic review and meta-analysis. Thorax,2009,64(9);757-762.

NAVANI N, LAWRENCE DR. KOLVEKAR S, et al. Endobronchial ultrasound-guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy; a prospective trial. Am J Respir Crit Care Med.2012.186(3) :255-260.

SEHGAL IS, DHOORIA S, AGGARWAL AN, et al. Endosonography versus mediastinoscopy in mediastinal staging of lung cancer; systematic review and meta-analysis. Ann Thorac Surg,2016.102(5): 1747-1755.

NAVANIN, MOLYNEAUX PL, BREEN RA, et al. Utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with tuberculous intrathoracic lymphadenopathy: a multicentre study. Thorax, 2011, 66 (10):889-893.

SENTURK A, ARGUDER E, HEZER H. et al. Rapid diagnosis of mediastinal tuberculosis with polymerase chain reaction evaluation of aspirated material taken by endobronchial ultrasound-guided transbronchial needle aspiration. J Investig Med,2014,62(6) ;885-889.

EOM JS, MOK JH, LEE MK, et al. Efficacy of TB-PCR using EBUS-TBNA samples in patients with intrathoracic granulomatous lymphadenopathy. BMC Pulm Med,2015,15 : 166 2016-12-12]. http://bmcpulmmed. biomedcentral. com/ articles/10. 1186/sl2890-015-0162-4. doi; 10. 1186/sl2890- 015-0162-4.

POPPER HH, WINTER E, HOFLER G. DNA of Mycobacterium tuberculosis in formalin-fixed, paraffin- embedded tissue in tuberculosis and sarcoidosis detected by polymerase chain reaction. Am J Clin Pathol. 1994 «101(6): 738-741.


Refbacks

  • There are currently no refbacks.