Ariza-Prota Miguel, Pérez-Pallarés Javier, Barisione Emanuela, Cruz-Rueda Juan José, Onyancha Sammy, Usturoi Daniela, De Santis Michele, Salcedo-Lobera Esperanza, Ferrer-Pargada Diego, Corcione Nadia, Caballero-Vázquez Alberto, Rodríguez-Blanco Ignacio, Torres-Rivas Héctor, Fernández-Fernández Luis, Velasco-Albendea Francisco Javier, García-Clemente Marta, López-González Francisco
Division of Respiratory Medicine, Interventional Pulmonology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain.
Division of Respiratory Medicine, Interventional Pulmonology Unit, Hospital Universitario Santa Lucía, Cartagena, Spain.
ERJ Open Res. 2025 Sep 8;11(5). doi: 10.1183/23120541.00775-2024. eCollection 2025 Sep.
The diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of lymphoma has a low overall sensitivity. The lack of tissue architecture obtained by cytological needles decreases the diagnostic accuracy for diagnosis and subtyping of and relapsed mediastinal lymphomas. This study compares the sensitivity of EBUS-TBNA and endobronchial ultrasound-guided transbronchial mediastinal cryobiopsy (EBUS-TMC) for both initial lymphoma diagnosis and recurrent cases, analyses safety, and evaluates the number of mediastinoscopies that could potentially be avoided due to this novel technique.
A multicentre retrospective observational study conducted on 40 patients who underwent both EBUS-TBNA and EBUS-TMC in the same procedure in which a definitive diagnosis of lymphoma was obtained from January 2023 to January 2024. EBUS-TBNA and EBUS-TMC were performed in the same lymph node station.
The overall sensitivity of EBUS-TMC was significantly higher compared to EBUS-TBNA alone and EBUS-TBNA+flow cytometry (95% 15% 25%). In new lymphoma cases, the sensitivity of EBUS-TMC surpassed that of EBUS-TBNA and EBUS-TBNA+flow cytometry (92% 15% 14%). In recurrent cases, EBUS-TMC showed a sensitivity of 100%, while EBUS-TBNA and EBUS-TBNA+flow cytometry had lower yields of 14% and 41%, respectively. No complications were reported.
EBUS-TMC demonstrates superior sensitivity compared to EBUS-TBNA in diagnosing and subtyping lymphoma, both in suspected new cases and recurrences. This technique reduces the need for procedural repetitions and avoids more invasive and costly interventions such as mediastinoscopy.
支气管内超声引导下经支气管针吸活检术（EBUS-TBNA）对淋巴瘤的诊断准确性总体敏感性较低。细胞学针获取的组织结构缺乏降低了初发及复发纵隔淋巴瘤诊断和亚型分类的诊断准确性。本研究比较了EBUS-TBNA和支气管内超声引导下经支气管纵隔冷冻活检术（EBUS-TMC）对初发淋巴瘤诊断及复发病例的敏感性，分析安全性，并评估由于这项新技术可能避免的纵隔镜检查数量。
一项多中心回顾性观察研究，对2023年1月至2024年1月期间在同一操作中同时接受EBUS-TBNA和EBUS-TMC并获得淋巴瘤确诊的40例患者进行研究。EBUS-TBNA和EBUS-TMC在同一淋巴结部位进行。
与单独的EBUS-TBNA和EBUS-TBNA+流式细胞术相比，EBUS-TMC的总体敏感性显著更高（95%对15%对25%）。在新发淋巴瘤病例中，EBUS-TMC的敏感性超过了EBUS-TBNA和EBUS-TBNA+流式细胞术（92%对15%对14%）。在复发病例中，EBUS-TMC的敏感性为100%，而EBUS-TBNA和EBUS-TBNA+流式细胞术的检出率较低，分别为14%和41%。未报告并发症。
在疑似新发病例和复发病例中，EBUS-TMC在淋巴瘤诊断和亚型分类方面显示出比EBUS-TBNA更高的敏感性。这项技术减少了操作重复的需要，避免了如纵隔镜检查等更具侵入性和成本更高的干预措施。
