The role of endobronchial ultrasound‐guided transbronchial needle aspiration liquid‐based cytology in the diagnosis of mediastinal lymphadenopathy

Autor: Chuan-Cai Xu, Chong-Jun Ni, Wei Lei, Jian-An Huang, Junhong Jiang, Lingyan Qin
Rok vydání: 2019
Předmět:
Adult
Male
endobronchial ultrasound (EBUS)
medicine.medical_specialty
Lung Neoplasms
Histology
Mediastinal lymphadenopathy
Lymphadenopathy
030209 endocrinology & metabolism
mediastinal lymphadenopathy
Mediastinal Neoplasms
Pathology and Forensic Medicine
liquid‐based cytology
03 medical and health sciences
0302 clinical medicine
Cytology
medicine
Humans
Sampling (medicine)
Endobronchial ultrasound
Neoplasm Metastasis
Lung cancer
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Aged
Retrospective Studies
Aged
80 and over
business.industry
Mediastinum
Original Articles
General Medicine
Gold standard (test)
Middle Aged
medicine.disease
Lymphoma
lung cancer
transbronchial needle aspiration (TBNA)
030220 oncology & carcinogenesis
Liquid-based cytology
Original Article
Female
Radiology
business
Zdroj: Diagnostic Cytopathology
ISSN: 1097-0339
8755-1039
DOI: 10.1002/dc.24374
Popis: Background Endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA) is a minimally invasive, reliable technique for sampling mediastinal lymph nodes (LNs). Liquid‐based cytology (LBC) is widely used for cervical cancer screening because it provides reliable and feasible results. The present study aimed to evaluate effectiveness of the combination of EBUS‐TBNA and LBC in the diagnosis of mediastinal lymphadenopathy. Methods A total of 602 LNs that were retrospectively analyzed were sampled in 442 patients who underwent EBUS‐TBNA between January 2014 and December 2016. The histopathological result of TBNA tissue or cell blocks was considered as the gold standard to evaluate diagnostic utility of LBC and conventional smears (CS) for the diagnosis of mediastinal lymphadenopathy. Results Of the 602 LNs, 265 were mediastinal LN metastases from lung cancer, four were lymphoma, and 333 were benign. The sensitivity of LBC and CS in the diagnosis of mediastinal LN metastases from lung cancer was 72.8% and 63%, respectively, and the specificity was 98.5% and 97%, respectively. The positive predictive values for LBC and CS were 97.5% and 94.4%, respectively, whereas the negative predictive values were 82.2% and 76.9%, respectively. The accuracy of LBC and CS was 88% and 83.7%, respectively. The diagnostic value of LBC was significantly higher than that of CS (P = .001). Conclusions The combination of EBUS‐TBNA and LBC is a highly reliable and feasible procedure that optimizes diagnostic utility for the diagnosis of lung cancer and mediastinal LN staging.
Databáze: OpenAIRE
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