The Role of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration in the Diagnosis of Recurrent Non-small Cell Lung Cancer after Surgery
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概要
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Objective Obtaining an accurate histopathological diagnosis is mandatory for the optimal treatment of patients who are suspected of having recurrent lung cancer. The purpose of this retrospective study was to investigate the usefulness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the diagnosis of recurrent non-small cell lung cancer (NSCLC) among patients who undergo curative surgical resection. Methods Consecutive patients who underwent convex probe EBUS-TBNA for mediastinal or hilar lymph node and peribronchial lung parenchymal lesions between May 2009 and May 2011 were included. The diagnostic sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated on a per-lesion and per-patient basis. Results Forty-two patients who were suspected of having recurrent NSCLC underwent EBUS-TBNA to assess 53 mediastinal and hilar lymph nodes and seven peribronchial lung parenchymal lesions. Among the 60 lesions, recurrence of malignancy was confirmed in 41 lesions on EBUS-TBNA (36 lymph nodes and five peribronchial lung lesions). On a per-lesion basis, the diagnostic sensitivity, specificity, accuracy, PPV and NPV of EBUS-TBNA for confirming recurrence were 95.3%, 100%, 96.6%, 100% and 88.9%, respectively. On a per-person basis, the diagnostic sensitivity, specificity, accuracy, PPV and NPV were 94.3%, 100%, 95.2%, 100% and 77.8%, respectively. No serious complications related to the procedures were observed. Conclusion Convex probe EBUS-TBNA is a sensitive method for diagnosing recurrent NSCLC in patients with lymph node and peribronchial lung parenchymal lesions. Therefore, EBUS-TBNA should be considered first for the cytopathological diagnosis of recurrent NSCLC.
著者
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Park Hye
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Su
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CHUNG Man
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Su
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KWON O
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Su
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Suh Gee
Division Of Pulmonary And Critical Care Medicine Department Of Medicine Samsung Medical Center Sungk
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Han Joungho
Department Of Diagnosis Pathology Samsung Medical Center
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Kim Hojoong
Division of Pulmonary & Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
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Kwon O
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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Um Sang-Won
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, South Korea
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Han Seo
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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Yoo Hongseok
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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Jhun Byung
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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Kwon O
Division of Pulmonary and Critical Care Medicine Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine
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Park Hye
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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Um Sang-Won
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Korea
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