Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 15;16(5):1757-1768.
doi: 10.62347/GDMG9203. eCollection 2024.

Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic lymphadenopathy in patients with nasopharyngeal cancer

Yu Gong  1   2 , Yufan Chen  1   2 , Jianjun Li  1   2 , Guoliang Xu  1   2 , Guangyu Luo  1   2
Affiliations

Endobronchial ultrasound-guided transbronchial needle aspiration in diagnosing intrathoracic lymphadenopathy in patients with nasopharyngeal cancer

Yu Gong et al. Am J Transl Res. .

Abstract

Objective: This study aimed to assess the efficacy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in detecting intrathoracic lymph nodes in patients with nasopharyngeal carcinoma (NPC).

Methods: Retrospective data analysis was conducted on individuals who underwent EBUS-TBNA between June 2015 and June 2022. Patients with NPC and enlarged intrathoracic lymph nodes were included. Specimens were categorized as malignant or non-malignant, with final non-malignancy confirmation procedures, or 12 months of clinical follow-up.

Results: Among 97 patients, 59 (60.8%) had NPC with intrathoracic lymph node metastasis, 3 (3.1%) had primary lung cancer involving nodes, and 25 (25.8%) showed benign characteristics. Ten cases (10.3%) were false-negative on initial EBUS-TBNA but confirmed as metastatic on follow-up. For NPC patients with intrathoracic lymphadenopathy, EBUS-TBNA exhibited 86.1% sensitivity (62/72), 71.4% negative predictive value (25/35), and 89.7% accuracy (87/97). Multivariate analysis identified increased lymph node short axis (OR: 1.200, 95% CI: 1.024-1.407; P = 0.041), metachronous NPC (OR: 11.274, 95% CI: 2.289-55.528; P = 0.003), and synchronous lung lesions (OR: 19.449, 95% CI: 1.875-201.753; P = 0.001) as independent predictors of malignant intrathoracic lymphadenopathy. Longer lymph node short axis (OR: 1.305, 95% CI: 1.044-1.631; P = 0.019) was independently associated with EBUS-TBNA accuracy.

Conclusion: EBUS-TBNA effectively diagnoses intrathoracic lymphadenopathy in NPC patients.

Keywords: Nasopharyngeal carcinoma; endobronchial ultrasound; intrathoracic lymphadenopathy; transbronchial needle aspiration.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
The diagnosis of nasopharyngeal carcinoma (NPC) with suspected intrathoracic metastases was confirmed in a 62-year-old patient through endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). A. Nasopharyngoscopy only revealed fibrosis and scarring changes in the nasopharyngeal mucosa. B. A chest computed tomography (CT) scan showed enlargement of the subcarinal lymph node. C. Localization and measurement of the subcarinal lymph node using EBUS. D. Real-time EBUS-TBNA with the needle positioned inside the lymph node. E. Aspiration of tissue samples during EBUS-TBNA. F. Retrieval of liquid-based cytology specimens during EBUS-TBNA.
Figure 2
Figure 2
Representative CT, positron emission tomography-computed tomography (PET-CT), and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) images of a 54-year-old patient with nasopharyngeal carcinoma (NPC) and suspected intrathoracic metastases. A. A chest CT examination revealed an enlarged right lower paratracheal lymph node. B. PET-CT demonstrated significant enhancement of the lymph node. C. Localization and measurement of the right lower paratracheal lymph node using EBUS. D. Real-time EBUS-TBNA with the needle positioned inside the lymph node. E. Cytology showing clusters of malignant epithelial cells (Papanicolaou staining ×40). F. Histology displaying NPC metastasis (hematoxylin-eosin staining ×40).
Figure 3
Figure 3
Flowchart of patient enrollment and final diagnosis. EBUS-TBNA, endobronchial ultrasound-guided transbronchial needle aspiration.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68:394–424. - PubMed
    1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet. 2019;394:64–80. - PubMed
    1. Chen YP, Wang ZX, Chen L, Liu X, Tang LL, Mao YP, Li WF, Lin AH, Sun Y, Ma J. A Bayesian network meta-analysis comparing concurrent chemoradiotherapy followed by adjuvant chemotherapy, concurrent chemoradiotherapy alone and radiotherapy alone in patients with locoregionally advanced nasopharyngeal carcinoma. Ann Oncol. 2015;26:205–211. - PubMed
    1. Zhang MX, Li J, Shen GP, Zou X, Xu JJ, Jiang R, You R, Hua YJ, Sun Y, Ma J, Hong MH, Chen MY. Intensity-modulated radiotherapy prolongs the survival of patients with nasopharyngeal carcinoma compared with conventional two-dimensional radiotherapy: a 10-year experience with a large cohort and long follow-up. Eur J Cancer. 2015;51:2587–2595. - PubMed
    1. Lee AW, Ng WT, Chan LL, Hung WM, Chan CC, Sze HC, Chan OS, Chang AT, Yeung RM. Evolution of treatment for nasopharyngeal cancer--success and setback in the intensity-modulated radiotherapy era. Radiother Oncol. 2014;110:377–384. - PubMed

LinkOut - more resources