| Application of endobronchial ultrasound-guided transbronchial needle aspiration following integrated PET/CT in mediastinal staging of potentially operable non-small cell lung cancer. | |
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MedLine Citation:
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PMID: 19118267 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The role of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) following integrated PET/CT scanning in mediastinal staging of non-small cell lung cancer (NSCLC) has not been assessed. METHODS: We prospectively evaluated the diagnostic values of PET/CT scanning and EBUS-TBNA for mediastinal staging in 117 patients with potentially operable NSCLC with accessible mediastinal lymph nodes (diameter range, 5 to 20 mm) by EBUS-TBNA. Subgroup analysis according to histologic type was performed. RESULTS: Of 30 cases of mediastinal metastasis, 27 were confirmed by EBUS-TBNA and 3 were confirmed by surgery. EBUS-TBNA results confirmed all cases with true-positive PET/CT scan findings and six of nine cases with false-negative PET/CT scan findings. The sensitivity, specificity, positive predictive value, negative predictive value (NPV), and accuracy of EBUS-TBNA in the detection of mediastinal metastasis were 90.0%, 100%, 100%, 96.7%, and 97.4%, respectively. For PET/CT scans, the values were 70.0%, 59.8%, 37.5%, 85.2%, and 62.4%, respectively (p = 0.052; p < 0.001; p < 0.001; p = 0.011; p < 0.001, respectively). In adenocarcinoma (n = 55), EBUS-TBNA detected four of six cases with false-negative PET/CT scan findings, and the NPV was higher for EBUS-TBNA than for PET/CT scans (94.6% vs 77.8%, respectively; p = 0.044). In squamous cell carcinoma (n = 53), the NPV of EBUS-TBNA and PET/CT scans were similarly high (97.9% vs 96.3%, respectively; p = 0.689). CONCLUSIONS: EBUS-TBNA was an effective invasive method following PET/CT scanning in the mediastinal staging of potentially operable NSCLC. In mediastinal PET/CT scan-positive cases, EBUS-TBNA was an excellent tool for detecting mediastinal metastasis. Even in mediastinal PET/CT scan-negative cases, EBUS-TBNA can be useful for confirming mediastinal metastases, especially in adenocarcinoma. |
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Authors:
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Bin Hwangbo; Seok Ki Kim; Hee-Seok Lee; Hyun Sung Lee; Moon Soo Kim; Jong Mog Lee; Hyae-Young Kim; Geon-Kook Lee; Byung-Ho Nam; Jae Ill Zo |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2008-12-31 |
Journal Detail:
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Title: Chest Volume: 135 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-07 Completed Date: 2009-06-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 1280-7 Citation Subset: AIM; IM |
Affiliation:
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Center for Lung Cancer, Research Institute for National Cancer Control & Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenocarcinoma
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pathology,
secondary,
surgery,
ultrasonography Adult Aged Aged, 80 and over Biopsy, Needle / methods Carcinoma, Non-Small-Cell Lung / pathology, secondary*, surgery, ultrasonography* Carcinoma, Squamous Cell / pathology, secondary, surgery, ultrasonography Endosonography Female Humans Lung Neoplasms / pathology* Male Mediastinal Neoplasms / secondary*, surgery, ultrasonography* Middle Aged Neoplasm Staging Positron-Emission Tomography Prospective Studies Thoracoscopy / methods Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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