Cargando…
Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions
BACKGROUND: Due to absence of visible endobronchial target, the diagnostic yield of flexible bronchoscopy for peribronchial lesions has been unsatisfactory. Convex probe endobronchial ultrasound (CP-EBUS) has allowed for performing real-time transbronchial needle aspiration (TBNA) of enlarged hilar...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221100/ https://www.ncbi.nlm.nih.gov/pubmed/28051017 http://dx.doi.org/10.4103/0366-6999.196567 |
_version_ | 1782492745072377856 |
---|---|
author | Chen, Cheng Mu, Chuan-Yong Su, Mei-Qin Mao, Jing-Yu Zhu, Ye-Han Huang, Jian-An |
author_facet | Chen, Cheng Mu, Chuan-Yong Su, Mei-Qin Mao, Jing-Yu Zhu, Ye-Han Huang, Jian-An |
author_sort | Chen, Cheng |
collection | PubMed |
description | BACKGROUND: Due to absence of visible endobronchial target, the diagnostic yield of flexible bronchoscopy for peribronchial lesions has been unsatisfactory. Convex probe endobronchial ultrasound (CP-EBUS) has allowed for performing real-time transbronchial needle aspiration (TBNA) of enlarged hilar and mediastinal lymph nodes and therefore could also be used as a means of diagnosing proximal peribronchial lesions. METHODS: We retrospectively analyzed the results related to 72 patients who underwent CP-EBUS for peribronchial lesions without endobronchial involvement and adjacent to three-grade bronchi based on chest computed tomography (CT) scan. We recorded the images during EBUS as well as the diagnostic results of TBNA and conventional-transbronchial lung biopsy/brush (C-TBLB/b), and final diagnoses were based on pathologic analysis and follow-up. RESULTS: In all cases, the mass was able to be identified using EBUS in 97.2% patients (70/72) who were performed with EBUS-TBNA + C-TBLB/b. Sixty-six patients had a final diagnosis, 80.0% patients (56/70) had malignancies, and 14.3% patients (10/70) had benign disease. In malignancies, the diagnostic yield of C-TBLB/b was 57.1% (32/56) and in EBUS-TBNA was 85.7% (48/56), whereas pathologic diagnosis reached 94.6% when EBUS-TBNA was combined with C-TBLB/b. C-TBLB/b + EBUS-TBNA also exhibited stronger potency of histolytic diagnosis for malignancies than either EBUS-TBNA or C-TBLB/b alone. Furthermore, there are data supporting the value of EBUS-TBNA for the diagnosis of benign lung disease. CONCLUSION: The combined endoscopic approach with EBUS-TBNA and C-TBLB/b is an accurate and effective method for the evaluation of peribronchial lesions, with better results than using each technique alone. |
format | Online Article Text |
id | pubmed-5221100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-52211002017-02-17 Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions Chen, Cheng Mu, Chuan-Yong Su, Mei-Qin Mao, Jing-Yu Zhu, Ye-Han Huang, Jian-An Chin Med J (Engl) Original Article BACKGROUND: Due to absence of visible endobronchial target, the diagnostic yield of flexible bronchoscopy for peribronchial lesions has been unsatisfactory. Convex probe endobronchial ultrasound (CP-EBUS) has allowed for performing real-time transbronchial needle aspiration (TBNA) of enlarged hilar and mediastinal lymph nodes and therefore could also be used as a means of diagnosing proximal peribronchial lesions. METHODS: We retrospectively analyzed the results related to 72 patients who underwent CP-EBUS for peribronchial lesions without endobronchial involvement and adjacent to three-grade bronchi based on chest computed tomography (CT) scan. We recorded the images during EBUS as well as the diagnostic results of TBNA and conventional-transbronchial lung biopsy/brush (C-TBLB/b), and final diagnoses were based on pathologic analysis and follow-up. RESULTS: In all cases, the mass was able to be identified using EBUS in 97.2% patients (70/72) who were performed with EBUS-TBNA + C-TBLB/b. Sixty-six patients had a final diagnosis, 80.0% patients (56/70) had malignancies, and 14.3% patients (10/70) had benign disease. In malignancies, the diagnostic yield of C-TBLB/b was 57.1% (32/56) and in EBUS-TBNA was 85.7% (48/56), whereas pathologic diagnosis reached 94.6% when EBUS-TBNA was combined with C-TBLB/b. C-TBLB/b + EBUS-TBNA also exhibited stronger potency of histolytic diagnosis for malignancies than either EBUS-TBNA or C-TBLB/b alone. Furthermore, there are data supporting the value of EBUS-TBNA for the diagnosis of benign lung disease. CONCLUSION: The combined endoscopic approach with EBUS-TBNA and C-TBLB/b is an accurate and effective method for the evaluation of peribronchial lesions, with better results than using each technique alone. Medknow Publications & Media Pvt Ltd 2017-01-05 /pmc/articles/PMC5221100/ /pubmed/28051017 http://dx.doi.org/10.4103/0366-6999.196567 Text en Copyright: © 2017 Chinese Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Chen, Cheng Mu, Chuan-Yong Su, Mei-Qin Mao, Jing-Yu Zhu, Ye-Han Huang, Jian-An Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title | Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title_full | Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title_fullStr | Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title_full_unstemmed | Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title_short | Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Increases the Yield of Transbronchial Lung Biopsy for the Evaluation of Peribronchial Lesions |
title_sort | endobronchial ultrasound-guided transbronchial needle aspiration increases the yield of transbronchial lung biopsy for the evaluation of peribronchial lesions |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5221100/ https://www.ncbi.nlm.nih.gov/pubmed/28051017 http://dx.doi.org/10.4103/0366-6999.196567 |
work_keys_str_mv | AT chencheng endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions AT muchuanyong endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions AT sumeiqin endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions AT maojingyu endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions AT zhuyehan endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions AT huangjianan endobronchialultrasoundguidedtransbronchialneedleaspirationincreasestheyieldoftransbronchiallungbiopsyfortheevaluationofperibronchiallesions |