Cargando…
Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test
BACKGROUND: As a minimally invasive method, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was more accurate than non-invasive methods such as positron emission tomography (PET) and computed tomography (CT) to evaluate the lymph nodes in preoperative non-small cell lung...
Autores principales: | , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
AME Publishing Company
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264044/ https://www.ncbi.nlm.nih.gov/pubmed/35813743 http://dx.doi.org/10.21037/jtd-22-521 |
_version_ | 1784742886000033792 |
---|---|
author | Nie, Shiwei Yu, Wencheng Hu, Xilin Xu, Hanlin Wen, Ruran Jiao, Wenjie Tian, Kaihua |
author_facet | Nie, Shiwei Yu, Wencheng Hu, Xilin Xu, Hanlin Wen, Ruran Jiao, Wenjie Tian, Kaihua |
author_sort | Nie, Shiwei |
collection | PubMed |
description | BACKGROUND: As a minimally invasive method, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was more accurate than non-invasive methods such as positron emission tomography (PET) and computed tomography (CT) to evaluate the lymph nodes in preoperative non-small cell lung cancer (NSCLC). PET/CT has more anatomical advantages than PET scanning and is more accurate in lung cancer staging. However, no relevant studies have comparatively evaluated PET/CT and EBUS-TBNA for NSCLC patients. METHODS: A total of 112 patients were included in this retrospective analysis. The golden diagnosis of N2 status was postoperative pathological results. In EBUS-TBNA puncture specimens, if clear malignant tumor cells could be seen, the results were taken as positive. In PET/CT image analysis, the CT values, short diameter, and maximum standardized uptake value (SUVmax) of each lymph node were recorded to evaluate N2 status. The results of PET/CT and EBUS-TBNA were compared with the final pathological results, and respective sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. - Then, the patients were divided into adenocarcinoma group and squamous cell carcinoma group -and the results were calculated and compared with the above method. RESULTS: The results showed that EBUS-TBNA had a higher diagnostic value for mediastinal lymph nodes than PET/CT, and the difference was statistically significant (P<0.001). In NSCLC patients, the results showed that the sensitivity (P=0.013), specificity (P<0.001), PPV (P<0.001), NPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than that of PET/CT (AUC =0.954 and 0.636, respectively). In adenocarcinoma cases, specificity (P<0.001), PPV (P<0.001), NPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than that of PET/CT (AUC =0.957 and 0.596, respectively).In cases with squamous cell carcinoma, specificity (P=0.003), PPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than PET/CT (AUC =0.952 and 0.657, respectively). CONCLUSIONS: For preoperative diagnosis of mediastinal lymph node metastases in NSCLC, EBUS-TBNA is more accurate than PET/CT. For those patients with suspected mediastinal lymph node metastasis, EBUS-TBNA should be preferred method to evaluate the status of mediastinal lymph nodes. |
format | Online Article Text |
id | pubmed-9264044 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | AME Publishing Company |
record_format | MEDLINE/PubMed |
spelling | pubmed-92640442022-07-09 Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test Nie, Shiwei Yu, Wencheng Hu, Xilin Xu, Hanlin Wen, Ruran Jiao, Wenjie Tian, Kaihua J Thorac Dis Original Article BACKGROUND: As a minimally invasive method, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was more accurate than non-invasive methods such as positron emission tomography (PET) and computed tomography (CT) to evaluate the lymph nodes in preoperative non-small cell lung cancer (NSCLC). PET/CT has more anatomical advantages than PET scanning and is more accurate in lung cancer staging. However, no relevant studies have comparatively evaluated PET/CT and EBUS-TBNA for NSCLC patients. METHODS: A total of 112 patients were included in this retrospective analysis. The golden diagnosis of N2 status was postoperative pathological results. In EBUS-TBNA puncture specimens, if clear malignant tumor cells could be seen, the results were taken as positive. In PET/CT image analysis, the CT values, short diameter, and maximum standardized uptake value (SUVmax) of each lymph node were recorded to evaluate N2 status. The results of PET/CT and EBUS-TBNA were compared with the final pathological results, and respective sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. - Then, the patients were divided into adenocarcinoma group and squamous cell carcinoma group -and the results were calculated and compared with the above method. RESULTS: The results showed that EBUS-TBNA had a higher diagnostic value for mediastinal lymph nodes than PET/CT, and the difference was statistically significant (P<0.001). In NSCLC patients, the results showed that the sensitivity (P=0.013), specificity (P<0.001), PPV (P<0.001), NPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than that of PET/CT (AUC =0.954 and 0.636, respectively). In adenocarcinoma cases, specificity (P<0.001), PPV (P<0.001), NPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than that of PET/CT (AUC =0.957 and 0.596, respectively).In cases with squamous cell carcinoma, specificity (P=0.003), PPV (P<0.001), and accuracy (P<0.001) of EBUS-TBNA were higher than PET/CT (AUC =0.952 and 0.657, respectively). CONCLUSIONS: For preoperative diagnosis of mediastinal lymph node metastases in NSCLC, EBUS-TBNA is more accurate than PET/CT. For those patients with suspected mediastinal lymph node metastasis, EBUS-TBNA should be preferred method to evaluate the status of mediastinal lymph nodes. AME Publishing Company 2022-06 /pmc/articles/PMC9264044/ /pubmed/35813743 http://dx.doi.org/10.21037/jtd-22-521 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
spellingShingle | Original Article Nie, Shiwei Yu, Wencheng Hu, Xilin Xu, Hanlin Wen, Ruran Jiao, Wenjie Tian, Kaihua Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title | Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title_full | Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title_fullStr | Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title_full_unstemmed | Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title_short | Positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of N2 in preoperative non-small cell lung cancer: a diagnostic test |
title_sort | positron emission tomography/computed tomography and endobronchial ultrasound-guided transbronchial needle aspiration to evaluate the status of n2 in preoperative non-small cell lung cancer: a diagnostic test |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264044/ https://www.ncbi.nlm.nih.gov/pubmed/35813743 http://dx.doi.org/10.21037/jtd-22-521 |
work_keys_str_mv | AT nieshiwei positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT yuwencheng positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT huxilin positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT xuhanlin positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT wenruran positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT jiaowenjie positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest AT tiankaihua positronemissiontomographycomputedtomographyandendobronchialultrasoundguidedtransbronchialneedleaspirationtoevaluatethestatusofn2inpreoperativenonsmallcelllungcanceradiagnostictest |