http://orcid.org/0000-0003-0692-4784
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Abstract
Objective: To determine the correlation and/or discrepancies between positron emission tomography (PET-CT) findings, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and surgery in the staging of non-small cell lung carcinoma.
Material and methods: Data were evaluated retrospectively from a prospective interventional endoscopy database. Positive results with EBUS-TBNA was the first end point and all cytology negatives were confirmed with mediastinoscopy/surgery.
Results: Four hundred and eighty three patients were included and 1017 lymph nodes (LNs) were sampled in the study. One hundred and twenty eight LNs were excluded (positive with EBUS-TBNA). Four hundred and sixty five LN (52.3%) were found benign with EBUS-TBNA; however, only 15 of these were confirmed to be malignant by surgery (1.7%). The sensitivity, specificity, PPV, NPV and diagnostic accuracy of EBUS-TBNA were 96.5, 100, 100, 96.7 and 98.3%, respectively. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of PET-CT for maximum standardized uptake value (SUVmax) 2.5 were 90.1, 29.2, 55.3, 75.4, 59.2%, respectively. A cut-off SUVmax of 5.2 was detected with 74.8% sensitivity, 84% specificity, 82.0% PPV, 77.5% NPV and 79.5% accuracy (area under the curve (AUC) of 0.818, 95% CI 0.791–0.843, p<.001).
Conclusion: EBUS is a reliable, repeatable and safe technique with a high diagnostic accuracy and should be performed quickly to avoid superfluous time loss in the staging of lung cancer.
| Abbreviations | ||
| PET-CT | = | F-18 fluorodeoxyglucose positron emission computed tomography |
| NSCLC | = | Non-small cell lung cancer |
| EBUS-TBNA | = | Endobronchial ultrasound-guided transbronchial needle aspiration |
| SUVmax | = | Maximum standardized uptake value |
| LNs | = | Lymph nodes |
| TTF-1 | = | Thyroid transcription factor-1 |
| H&E | = | Hematoxylin and eosin; Med: Mediastinoscopy |
| VATS | = | Video associated thoracic surgery |
| AUC | = | Area under curve |
| OR | = | Odds ratio |
| CI | = | Confidence intervals |
Declaration of interest
All authors declared no conflict of interest. This research received no financial support.