Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13227
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
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.
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.
In this study, we describe our experience with the use of EBUS-TBNA in patients with extrathoracic malignancies due to intrathoracic lymphadenopathy.
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 ca
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.
EBUS-TBNA is a simple and accurate procedure for the diagnosis of intrathoracic lymphadenopathy with extrathoracic malignancy. Its application resulted in no major complications.
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.