Chest
Original ResearchInterventional PulmonologyApplication of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration Following Integrated PET/CT in Mediastinal Staging of Potentially Operable Non-small Cell Lung Cancer
Section snippets
Patients
In this prospective study, consecutive patients with histologically confirmed or strongly suspected potentially operable NSCLC were enrolled from October 2006 to October 2007. Patients were required to have at least one mediastinal lymph node in an accessible location by EBUS-TBNA, with a short diameter of 5 to 20 mm on chest CT scan axial image. Surgical tumor resectability was evaluated after staging workup for NSCLC, including CT scan of the chest and upper abdomen, integrated PET/CT scan,
Patients
We enrolled 129 patients in the study (Fig 1) and safely performed EBUS-TBNA on all without complications. Two patients ultimately were given a diagnosis of small cell lung cancer and one with organizing pneumonia. Of the 126 remaining patients, 9 could not be evaluated (ie, 7 refused surgery, and 2 did not undergo lymph node dissection because of unexpected pleural metastasis found during surgery). Table 1 shows the characteristics of the 117 evaluated patients and the lymph node findings.
EBUS-TBNA and Surgical Lymph Node Dissection
Discussion
In this study, EBUS-TBNA had high diagnostic values that were superior to integrated PET/CT scan in the mediastinal staging of potentially operable NSCLC. We found that EBUS-TBNA was more sensitive than PET/CT scan, although the difference was of borderline statistical significance. EBUS-TBNA had significantly higher specificity, PPV, NPV, and accuracy than PET/CT scan. These results show that EBUS-TBNA is an effective invasive method for mediastinal staging after PET/CT scan is performed. The
Conclusions
EBUS-TBNA, which is more accurate than integrated PET/CT scanning, is an effective invasive method in the mediastinal staging of potentially operable NSCLC after PET/CT scanning is performed. EBUS-TBNA is an excellent tool for detecting mediastinal metastasis in mediastinal PET/CT scan-positive, potentially operable NSCLC and should be considered for patients with this condition. Even in mediastinal PET/CT scan-negative cases, EBUS-TBNA can be helpful in confirming mediastinal metastasis,
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Cited by (0)
This work was supported by National Cancer Center grant 710620.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).