Aljohaney Ahmed, Bakhsh Salwa, Khayat Manal
Internal Medicine, King Abdulaziz University Hospital, Jeddah, SAU.
Pathology, King Abdulaziz University Hospital, Jeddah, SAU.
Cureus. 2023 May 29;15(5):e39673. doi: 10.7759/cureus.39673. eCollection 2023 May.
Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a diagnostic procedure that allows clinicians to stage lung cancer by sampling lymph nodes in the mediastinum. EBUS-TBNA is recommended as a first step prior to mediastinoscopy for lung cancer mediastinal staging. This procedure has greatly aided pulmonologists in diagnosing mediastinal pathologies with substantial progress. In this study, our aim is to analyze how cell blocks affect the diagnostic yield of mediastinal and hilar lymphadenopathy using an EBUS cytology needle. Methods This retrospective study was conducted at King Abdulaziz University Hospital between May 2021 and September 2021. Patients with mediastinal and hilar lymphadenopathy in the absence of known or suspected primary lung cancer were included. The EBUS procedure was performed using a flexible bronchoscope equipped with a working channel suitable for transbronchial needle aspiration under direct ultrasound guidance. Data were recorded using Microsoft Excel and analyzed using Statistical Package for the Social Sciences (SPSS) v. 26.0 (IBM Corp., Armonk, NY). Diagnostic accuracy measures were determined, and a p-value of 0.05 was established as the final threshold for statistical significance. Results The total number of patients in our study was 151. The sensitivity for cytology specimens, histology specimens, and a combined evaluation for the full group of patients was 77.14%, 83.33%, and 87.5%, respectively, with a negative predictive value of 27.22%, 25%, and 21.42%. The diagnostic accuracy for cytology specimens, histology specimens, and a combined evaluation was 71.42%, 76.19%, and 80%, respectively. Conclusion Our study found that the combined examination of specimens for both cytology and histology in the diagnosis of lung cancer, sarcoidosis, and tuberculosis resulted in a higher diagnostic yield compared to cytological assessment alone using EBUS-TBNA.
背景 支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）是一种诊断方法，可让临床医生通过对纵隔淋巴结进行采样来对肺癌进行分期。EBUS-TBNA被推荐为在纵隔镜检查之前对肺癌纵隔分期的第一步。该操作极大地帮助了肺科医生诊断纵隔病变，取得了实质性进展。在本研究中，我们的目的是分析细胞块如何使用EBUS细胞学针影响纵隔和肺门淋巴结病的诊断率。方法 本回顾性研究于2021年5月至2021年9月在阿卜杜勒阿齐兹国王大学医院进行。纳入无已知或疑似原发性肺癌的纵隔和肺门淋巴结病患者。在直接超声引导下，使用配备有适合经支气管针吸活检工作通道的柔性支气管镜进行EBUS操作。数据使用Microsoft Excel记录，并使用社会科学统计软件包（SPSS）v. 26.0（IBM公司，纽约州阿蒙克）进行分析。确定诊断准确性指标，并将p值0.05确定为统计学显著性的最终阈值。结果 我们研究中的患者总数为151例。细胞学标本、组织学标本以及对全组患者的综合评估的敏感性分别为77.14%、83.33%和87.5%，阴性预测值分别为27.22%、25%和21.42%。细胞学标本、组织学标本以及综合评估的诊断准确性分别为71.42%、76.19%和80%。结论 我们的研究发现，在肺癌、结节病和结核病的诊断中，对细胞学和组织学标本进行联合检查比单独使用EBUS-TBNA进行细胞学评估具有更高的诊断率。
