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[Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer diagnosis and staging in 179 patients].

Research paper by A A Bugalho, D D Ferreira, R R Barata, C C Rodrigues, S S SS Dias, F F Medeiros, L L Carreiro

Indexed on: 16 Jul '13Published on: 16 Jul '13Published in: Revista Portuguesa de Pneumologia



Abstract

Linear endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an important minimally invasive procedure for non-small cell lung cancer (NSCLC) staging. It is also a valid method for diagnosing extraluminal lesions adjacent to the tracheobronchial tree.To evaluate our EBUS-TBNA performance regarding diagnostic yield, safety and learning curve for lung cancer diagnosis and staging.All patients undergoing EBUS-TBNA for lung cancer diagnosis or staging were included. They were divided into three different groups: paratracheal and parabronchial masses sent for diagnosis (Group 1); peripheral lung lesions with abnormal mediastinal lymph nodes sent for diagnosis and staging (Group 2); NSCLC patients sent for mediastinal staging (Group 3). The learning curve was assessed for yield, accuracy, procedure time, size and number of lesions punctured per patient.A total of 179 patients were included and 372 lesions were punctured. The overall yield and accuracy were 88% and 92.7%, respectively. In Group 1, EBUS-TBNA was performed in 48 patients and sensitivity was 86.1% and accuracy was 87.5%. For the 87 patients included in Group 2, yield was 86.7%, accuracy was 93.1% and cancer prevalence was 51.7%. The diagnostic yield and accuracy in Group 3 was 95% and 97.7% respectively. EBUS-TBNA practice led to an increase number of sites punctured per patient in a shorter time, without complications.EBUS-TBNA is an effective method for diagnosing and staging lung cancer patients. The procedure is clearly safe. Handling and performance improves with the number of procedures executed.