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首页> 外文期刊>Ultrasound in Medicine and Biology >Representativeness of Nodal Sampling With Endobronchial Ultrasonography in Non-Small-Cell Lung Cancer Staging
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Representativeness of Nodal Sampling With Endobronchial Ultrasonography in Non-Small-Cell Lung Cancer Staging

机译：支气管内超声在非小细胞肺癌分期中取样的代表性

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The objective of our study was to determine the procedure-related requirements of mediastinal node sampling with endobronchial ultrasonography with real-time transbronchial needle aspiration (EBUS-TBNA) that would provide negative predictive value (NPV) for the identification of stage III disease in non-small-cell lung cancer (NSCLC) high enough to consider the technique equivalent to cervical mediastinoscopy. Representative EBUS-TBNA was defined as a sampling procedure obtaining satisfactory samples from normal nodes in regions 4R, 4L and 7 or diagnosing malignancy in mediastinal nodes. NPV was estimated using the results of postsurgical staging in patients who underwent surgery as a reference. Two-hundred ninety-six patients staged with EBUS-TBNA were included. Representative samples from regions 4R, 4L and 7 showing nonmalignant cytology were obtained from 98 patients (33.1%) and EBUS-TBNA detected N2/N3 disease in 150 (50.7%). Accordingly, an EBUS-TBNA procedure accomplishing the representativeness criteria required for sampling was attained in 248 of the participating patients (83.8%). The NPV of the procedure in this setting was 93.6%, with false-negative results only found in 5 patients, four of them with nodal metastasis out of the reach of EBUS-TBNA (regions 5, 8 and 9). In conclusion, representative sampling of regions 4R, 4L and 7 is achieved in more than 80% of patients staged using EBUS-TBNA, and in the procedures that attain this requirement a NPV >90% for mediastinal malignancy is reached, a figure equivalent to cervical mediastinoscopy.
机译：我们研究的目的是确定与纵隔淋巴结清扫术相关的要求，采用实时经支气管针吸术（EBUS-TBNA）进行支气管内超声检查，这将为非III期疾病的鉴别提供阴性预测价值（NPV）。 -小细胞肺癌（NSCLC）的高度足以考虑与宫颈纵隔镜检查等效的技术。代表性的EBUS-TBNA被定义为一种采样程序，可从4R，4L和7区的正常淋巴结中获得满意的样本，或诊断纵隔淋巴结中的恶性肿瘤。 NPV是根据接受手术的患者的术后分期结果估算的。纳入了269例接受EBUS-TBNA分期的患者。从98名患者（33.1％）获得了来自4R，4L和7区的显示非恶性细胞学的代表性样品，EBUS-TBNA在150名患者中检出了N2 / N3疾病（50.7％）。相应地，在248名参试患者中达到了EBUS-TBNA程序，该程序达到了采样所需的代表性标准（83.8％）。在这种情况下，该程序的NPV为93.6％，仅在5例患者中发现假阴性结果，其中4例在EBUS-TBNA无法触及的范围内发生了淋巴结转移（5、8和9区）。总之，在超过80％的使用EBUS-TBNA分期的患者中实现了区域4R，4L和7的代表性采样，在达到此要求的程序中，达到了纵隔恶性NPV> 90％宫颈纵隔镜检查。

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