Journal of bronchology & interventional pulmonology · 2013
Endobronchial ultrasound-guided transbronchial needle aspiration in an unselected cohort.
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Gindesgaard Christian B, Schousboe Lars P, Christensen Rikke K
Аннотация
BACKGROUND: Endobronchial ultrasound (EBUS) with transbronchial needle aspiration (TBNA) is widely used as a diagnostic tool. The aim of this study was to evaluate the sensitivity and diagnostic accuracy of EBUS-TBNA for detecting malignant cells or sarcoidosis in mediastinal, hilar, and lobar lymph nodes.
METHODS: A retrospective chart review was made on all the patients, on whom an EBUS-TBNA was performed in 2009, in total 129 patients.
RESULTS: The sensitivity and accuracy of EBUS-TBNA for the diagnosis of neoplastic disease were 87% [95% confidence interval (CI), 77-97] and 95% (95% CI, 91-99) on a per patient basis. In 5 cases, the malignancies were inaccessible from the airway or a lymphoma. If these were excluded the sensitivity and accuracy became 98% (95% CI, 94-100) and 99% (95% CI, 97-100).In 13 cases it was not possible to conclusively determine the true status of the lymph nodes by either surgery or follow-up, if these were all assumed to be true negative the sensitivity and accuracy became 87% (95% CI, 77-97) and 95% (95% CI, 91-99), and if they were assumed to be false negative the sensitivity and accuracy became 68% (95% CI, 56-80) and 85% (95% CI, 79-91). For the diagnosis of sarcoidosis, the sensitivity and accuracy were 83% (95% CI, 69-97) and 96% (95% CI, 93-99).
CONCLUSIONS: EBUS-TBNA is a very sensitive examination in regards to carcinoma in locations accessible from the airways, but it is not suitable for the diagnosis of lymphoma. It also adds pathologic information to make the diagnosis of sarcoidosis.
METHODS: A retrospective chart review was made on all the patients, on whom an EBUS-TBNA was performed in 2009, in total 129 patients.
RESULTS: The sensitivity and accuracy of EBUS-TBNA for the diagnosis of neoplastic disease were 87% [95% confidence interval (CI), 77-97] and 95% (95% CI, 91-99) on a per patient basis. In 5 cases, the malignancies were inaccessible from the airway or a lymphoma. If these were excluded the sensitivity and accuracy became 98% (95% CI, 94-100) and 99% (95% CI, 97-100).In 13 cases it was not possible to conclusively determine the true status of the lymph nodes by either surgery or follow-up, if these were all assumed to be true negative the sensitivity and accuracy became 87% (95% CI, 77-97) and 95% (95% CI, 91-99), and if they were assumed to be false negative the sensitivity and accuracy became 68% (95% CI, 56-80) and 85% (95% CI, 79-91). For the diagnosis of sarcoidosis, the sensitivity and accuracy were 83% (95% CI, 69-97) and 96% (95% CI, 93-99).
CONCLUSIONS: EBUS-TBNA is a very sensitive examination in regards to carcinoma in locations accessible from the airways, but it is not suitable for the diagnosis of lymphoma. It also adds pathologic information to make the diagnosis of sarcoidosis.