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. 2015 May-Jun;41(3):219-24.
doi: 10.1590/S1806-37132015000004466.

Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

[Article in English, Spanish]
Sebastián Fernández-Bussy  1 , Gonzalo Labarca  2 , Sofia Canals  1 , Iván Caviedes  1 , Erik Folch  3 , Adnan Majid  3
Affiliations

Diagnostic yield of endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal staging in lung cancer

[Article in English, Spanish]
Sebastián Fernández-Bussy et al. J Bras Pneumol. 2015 May-Jun.

Abstract
in English, Spanish

Objective: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive diagnostic test with a high diagnostic yield for suspicious central pulmonary lesions and for mediastinal lymph node staging. The main objective of this study was to describe the diagnostic yield of EBUS-TBNA for mediastinal lymph node staging in patients with suspected lung cancer.

Methods: Prospective study of patients undergoing EBUS-TBNA for diagnosis. Patients ≥ 18 years of age were recruited between July of 2010 and August of 2013. We recorded demographic variables, radiological characteristics provided by axial CT of the chest, location of the lesion in the mediastinum as per the International Association for the Study of Lung Cancer classification, and definitive diagnostic result (EBUS with a diagnostic biopsy or a definitive diagnostic method).

Results: Our analysis included 354 biopsies, from 145 patients. Of those 145 patients, 54.48% were male. The mean age was 63.75 years. The mean lymph node size was 15.03 mm, and 90 lymph nodes were smaller than 10.0 mm. The EBUS-TBNA method showed a sensitivity of 91.17%, a specificity of 100.0%, and a negative predictive value of 92.9%. The most common histological diagnosis was adenocarcinoma.

Conclusions: EBUS-TBNA is a diagnostic tool that yields satisfactory results in the staging of neoplastic mediastinal lesions.

OBJETIVO:: La ultrasonografía endobronquial con aspiración transbronquial por aguja fina (EBUS-TBNA, por sus siglas en inglés) es una alternativa mínimamente invasiva con un alto rendimiento diagnóstico para lesiones pulmonares centrales sospechosas de cáncer o para etapificación de linfonodos mediastínicos. El objetivo principal de este trabajo es describir el rendimiento de EBUS-TBNA como método de etapificación de linfonodos mediastínicos en pacientes con sospecha de cáncer pulmonar.

MÉTODOS:: Estudio prospectivo de pacientes sometidos a EBUS-TBNA como método diagnóstico. Se seleccionaron pacientes mayores de 18 años entre julio del 2010 y agosto del 2013. Se registraron variables demográficas, características radiológicas mediante TC axial de tórax, localización mediastínica según clasificación de la International Association for the Study of Lung Cancer y resultado diagnóstico definitivo (EBUS con biopsia diagnóstica o método diagnóstico definitivo).

RESULTADOS:: Se incluyeron 145 pacientes con un total de 354 biopsias. El 54,48% de los pacientes eran hombres, con edad promedio de 63,75 años. El tamaño promedio de los linfonodos fue de 15,03 mm, y 90 fueron menores de 10,0 mm. El rendimiento diagnóstico fue: sensibilidad, 91,17%; especificidad, 100,0%; y valor predictivo negativo, 92,9%. El diagnóstico histológico más frecuente fue adenocarcinoma.

CONCLUSIONES:: EBUS-TBNA es una herramienta diagnóstica con buenos resultados en el estudio de etapificación de lesiones neoplásicas en mediastino.

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