Document Detail


Application of endobronchial ultrasound-guided transbronchial needle aspiration following integrated PET/CT in mediastinal staging of potentially operable non-small cell lung cancer.
MedLine Citation:
PMID:  19118267     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-12-31
Journal Detail:
Title:  Chest     Volume:  135     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-07     Completed Date:  2009-06-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1280-7     Citation Subset:  AIM; IM    
Affiliation:
Center for Lung Cancer, Research Institute for National Cancer Control & Evaluation, National Cancer Center, Goyang, Gyeonggi, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / 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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