系统性联合支气管内超声与内镜超声（EBUS-EUS）提高肺癌诊断与分期的准确性和敏感性：来自三级中心的经验

Improved Accuracy and Sensitivity in Diagnosis and Staging of Lung Cancer with Systematic and Combined Endobronchial and Endoscopic Ultrasound (EBUS-EUS): Experience from a Tertiary Center.

作者信息

Badaoui Abdenor, De Wergifosse Marion, Rondelet Benoit, Deprez Pierre H, Stanciu-Pop Claudia, Bairy Laurent, Eucher Philippe, Delos Monique, Ocak Sebahat, Gillain Cédric, Duplaquet Fabrice, Pirard Lionel

机构信息

Department of Gastroenterology and Hepatology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium.

Department of Pneumology, CHU UCL Namur, Université catholique de Louvain, 5530 Yvoir, Belgium.

出版信息

Cancers (Basel). 2024 Feb 9;16(4):728. doi: 10.3390/cancers16040728.

DOI:10.3390/cancers16040728

PMID:38398119

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10886864/

Abstract

BACKGROUND

Combined endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided tissue acquisition (EUS-TA) are accurate procedures for the diagnosis and staging of mediastinal lymph nodes (MLNs) in lung cancer. However, the respective contribution of separate and combined procedures in diagnosis and staging has not been fully studied. The aim of this study was to assess their respective performances.

METHODS

Patients with suspected malignant MLNs in lung cancer or recurrence identified by PET-CT who underwent combined EBUS-TBNA and EUS-TA were retrospectively reviewed.

RESULTS

A total of 141 patients underwent both procedures. Correct diagnosis was obtained in 82% with EBUS-TBNA, 91% with EUS-TA, and 94% with the combined procedure. The overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of EBUS-TBNA, EUS-TA, and the combined procedure for diagnosing malignancy were [75%, 100%, 100%, 58%], [87%, 100%, 100%, 75%], and [93%, 100%, 100%, 80%], respectively, with a significantly better sensitivity of the combined procedure ( < 0.0001). Staging (82/141 patients) was correctly assessed in 74% with EBUS-TBNA, 68% with EUS-TA, and 85% with the combined procedure. The overall sensitivity, specificity, PPV, and NPV of EBUS-TBNA, EUS-TA, and the combined procedure for lung cancer staging were [62%, 100%, 100%, 55%], [54%, 100%, 100%, 50%], and [79%, 100%, 100%, 68%], respectively, significantly better in terms of sensitivity for the combined procedure ( < 0.001).

CONCLUSION

The combined EBUS-EUS approach in lung cancer patients showed better accuracy and sensitivity in diagnosis and staging when compared with EBUS-TBNA and EUS-TA alone.

摘要

背景

支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）和内镜超声引导下组织获取术（EUS-TA）是肺癌纵隔淋巴结（MLNs）诊断和分期的准确方法。然而，单独及联合操作在诊断和分期中的各自贡献尚未得到充分研究。本研究的目的是评估它们各自的性能。

方法

对经PET-CT确诊为肺癌或复发且疑似恶性MLNs并接受EBUS-TBNA和EUS-TA联合检查的患者进行回顾性分析。

结果

共有141例患者接受了这两种检查。EBUS-TBNA的正确诊断率为82%，EUS-TA为91%，联合检查为94%。EBUS-TBNA、EUS-TA及联合检查诊断恶性肿瘤的总体敏感性、特异性、阳性和阴性预测值（PPV和NPV）分别为[75%，100%，100%，58%]、[87%，100%，100%，75%]和[93%，100%，100%，80%]，联合检查的敏感性显著更高（<0.0001）。141例患者中有82例进行了分期评估，EBUS-TBNA的正确分期率为74%，EUS-TA为68%，联合检查为85%。EBUS-TBNA、EUS-TA及联合检查对肺癌分期的总体敏感性、特异性、PPV和NPV分别为[62%，100%，100%，55%]、[54%，100%，100%，50%]和[79%，100%，100%，68%]，联合检查的敏感性显著更高（<0.001）。