Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2022; 10(36): 13227-13238
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13227
Endobronchial ultrasound-guided transbronchial needle aspiration in intrathoracic lymphadenopathy with extrathoracic malignancy
Shi-Jie Li, Qi Wu
Shi-Jie Li, Endoscopy Center, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China
Qi Wu, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100142, China
Author contributions: Li SJ and Wu Q carried out the studies; Li SJ performed the analyses and collected the data; Li SJ drafted the manuscript; Wu Q conceived and designed the study; All authors approved the final draft submitted.
Supported by The Wu Jieping Medical Foundation Special Fund for Clinical Research, No. 320.6750.2021-04-71; Open Research Fund of NHC Key Laboratory of Prevention and Treatment of Central Asia High Incidence Diseases, No. KF202101; and Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences, No. 2020-PT330-003.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Peking University Cancer Hospital (Approval No. 2018YJZ72).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: Contact lishijie@bjmu.edu.cn to obtain the anonymized dataset.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qi Wu, MD, Chief Physician, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, No. 8 Fucheng Road, Haidian District, Beijing 100142, China. wuqi1973@bjmu.edu.cn
Received: July 7, 2022
Peer-review started: July 7, 2022
First decision: October 27, 2022
Revised: November 7, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
ARTICLE HIGHLIGHTS
Research background

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is an established technique for the diagnosis of mediastinal and hilar lymphadenectasis in primary lung cancer, but is poorly studied in patients with extrathoracic malignancies.

Research motivation

Regular follow-up and surveillance are essential in cancer patients, and the detection of intrathoracic lymphadenopathy in those with extrathoracic malignancies is not uncommon. EBUS-TBNA is recommended for tissue sampling both in mediastinal and hilar lymph nodes in lung cancer. Data on the usefulness of this technique in patients with extrathoracic malignancies remain limited.

Research objectives

In this study, we describe our experience with the use of EBUS-TBNA in patients with extrathoracic malignancies due to intrathoracic lymphadenopathy.

Research methods

The results of the sample acquired by EBUS-TBNA were defined as positive for malignancy, negative for non-malignancy (tuberculosis, sarcoidosis, etc.), and without definite diagnosis. Sensitivity, negative predictive value (NPV) for malignancy, and overall accuracy were calculated. Complications were recorded.

Research results

The diagnostic sensitivity, NPV, and accuracy of EBUS-TBNA for intrathoracic lymphadenopathy in patients with extrathoracic malignancy were 93.8% (n = 60/64), 80.0% (n = 16/20), and 95.0% (n = 76/80), respectively. Longer short axis of the lymph node (P = 0.024) and synchronous lung lesion (P = 0.013) were independently associated with malignant intrathoracic lymphadenopathy. No major complication was observed.

Research conclusions

EBUS-TBNA is a simple and accurate procedure for the diagnosis of intrathoracic lymphadenopathy with extrathoracic malignancy. Its application resulted in no major complications.

Research perspectives

This retrospective study demonstrates that EBUS-TBNA is effective and safe for diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy. Additional prospective studies are warranted to establish standards for higher diagnostic yield.