Clinical Implication of Microscopic Anthracotic Pigment in Mediastinal Staging of Non-Small Cell Lung Cancer by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration.
10.3346/jkms.2013.28.4.550
- Author:
Young Sik PARK
1
;
Jinwoo LEE
;
Jin Chul PANG
;
Doo Hyun CHUNG
;
Sang Min LEE
;
Jae Joon YIM
;
Seok Chul YANG
;
Chul Gyu YOO
;
Young Whan KIM
;
Sung Koo HAN
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. mdyspark@gmail.com
- Publication Type:Original Article
- Keywords:
Lung Cancer;
Staging;
Endobronchial Ultrasound;
Anthracotic Pigment
- MeSH:
Adult;
Aged;
Aged, 80 and over;
Bronchoscopy;
Carbon/chemistry;
Carcinoma, Non-Small-Cell Lung/*pathology;
Endoscopic Ultrasound-Guided Fine Needle Aspiration;
Female;
Humans;
Lung Neoplasms/*pathology;
Lymph Nodes/pathology;
Lymphatic Metastasis;
Male;
Mediastinal Neoplasms/*pathology;
Middle Aged;
Multivariate Analysis;
Neoplasm Staging;
Positron-Emission Tomography
- From:Journal of Korean Medical Science
2013;28(4):550-554
- CountryRepublic of Korea
- Language:English
-
Abstract:
Microscopic anthracotic pigment (MAP) is frequently observed in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) specimen in non-small cell lung cancer, but its clinical interpretation is not well-known. The aim of this study was to evaluate the clinical implication of MAP in mediastinal staging of non-small cell lung cancer. From May 2010 to July 2011, consecutive potentially operable non-small cell lung cancer patients who underwent EBUS-TBNA for mediastinal staging were recruited. Of the total 133 patients, 102 (76.7%) were male patients. Median age was 68 yr. Total 279 mediastinal lymph nodes were sampled by EBUS-TBNA; station 4R (100, 35.8%) and station 7 (86, 30.8%) were the most common sites. Malignant lymph nodes were 100 (35.8%). MAP was observed in 61 (21.7%) lymph nodes, and among them only 3 were malignant lymph nodes (P < 0.001). The lymph nodes with MAP were smaller (9.0 vs 10.8 mm, P = 0.001) and showed low standard uptake values on FDG-PET (4.4 vs 4.7, P = 0.256). In multivariate analysis, MAP was negatively associated with malignant lymph node (adjusted OR, 0.12; 95% CI, 0.03-0.42; P < 0.001). In potentially operable non-small cell lung cancer patients, MAP in endobronchial ultrasound-guided transbronchial needle aspiration specimens is strongly associated with benign mediastinal and hilar lymph nodes.
