학술논문

Endobronchial ultrasound- guided transbronchial needle aspiration for mediastinal lymph node staging in patients with typical pulmonary carcinoids.
Document Type
Article
Source
Lung Cancer (01695002). Sep2020, Vol. 147, p198-203. 6p.
Subject
*LYMPHADENECTOMY
*LYMPH nodes
*NON-small-cell lung carcinoma
*SURGICAL excision
*CARCINOID
Language
ISSN
0169-5002
Abstract
• Sensitivity of EBUS TBNA for staging of typical carcinoid was lower than for non-small cell lung cancer. • Preoperative EBUS-TBNA identified nodal metastases not detected by imaging. • A significant fraction of patients (15 %) with typical carcinoid had lymph node metastases. Pulmonary carcinoids, which are well-differentiated lung neuroendocrine carcinomas, account for only 1–2 % of primary lung malignancies. Although fluorodeoxyglucose positron-emission tomography/computed tomography performs poorly in the identification of mediastinal lymph node metastases, particularly for pulmonary carcinoids, endobronchial ultrasound-guided (EBUS) transbronchial needle aspiration (TBNA) may be a useful means of preoperative nodal assessment in patients with these conditions. However, the diagnostic performance of EBUS TBNA is unknown. This study was designed to determine the sensitivity of EBUS for mediastinal staging in patients with typical carcinoid. A retrospective review of all patients with carcinoids who underwent EBUS TBNA and/or surgical resection with lymphadenectomy at The University of Texas MD Anderson Cancer Center was performed. The sensitivity of EBUS –TBNA in diagnosis of mediastinal lymph node metastases was determined. Of the 212 patients with pulmonary carcinoids we identified, 137 had surgery with no preoperative EBUS TBNA, 68 had EBUS TBNA followed by surgery, and 7 had EBUS TBNA only. The sensitivity rate for EBUS TBNA in diagnosis of mediastinal lymph node metastases was 77.78 % overall (95 % CI, 57.7−91.3%) and it was 87.5 % (95 % CI, 67.6−97.3%) when we considered only patients with EBUS TBNA-accessible lymph nodes. The sensitivity of EBUS TBNA for diagnosis of mediastinal lymph node metastases of pulmonary carcinoids was slightly lower than that reported previously for non-small cell lung cancer. Preoperative EBUS TBNA identified nodal metastases not previously identified by imaging. [ABSTRACT FROM AUTHOR]