Objective: To explore the diagnostic values of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with hilar and mediastinal tumors.
Methods: A total of 837 patients with chest CT or PET/CT confirmed mediastinal/hilar lymphadenopathy and or tumors in (or around) the trachea or bronchi, were evaluated by EBUS-TBNA examination. Pathological study or follow-up visit was carried out in the same period to make a final diagnosis, and therefore to verify the accuracy of EBUS-TBNA.
Result: The study punctured 1631 lymph nodes totally, with an average of 1.95 times per case. The 4R group and the 7th group of lymph nodes accounted for 43% and 34%, respectively. The success rate of TBNA was 100%. The diagnosis rates of lung cancer was 94.11%, of which squamous cell carcinoma accounted for 19.22% (89 cases), adenocarcinoma 32.40% (150 cases), small cell carcinoma 23.54% (109 cases), non-small cell carcinoma of unknown histological type 9.50% (44 cases), adenosquamous carcinoma 7.56% (35 cases), and other types 7.78% (36 cases). The diagnosis rate of tuberculosis was 85.50%, and that of sarcoidosis was 55.88%. The overall sensitivity of EBUS-TBNA was 94.02%, specificity 100%, positive predictive value 100%, negative predictive value 61.91%, and the accuracy was 94.56%. Besides mild bleeding in the puncture site, no other complications occurred, and there were no severe complications such as pneumothorax, pneumomediastinum, or major vascular injury.
Conclusion: EBUS-TBNA is of high value as a minimally invasive, convenient, and low-risk procedure for the diagnosis of mediastinal and hilar lymphadenopathy and tumors.