Next Steps after Negative Results Obtained by EBUS-TBNA from Patients Suspected Clinically Lung Cancer with Mediastinal Lymphnode Metastasis.
10.3779/j.issn.1009-3419.2019.04.04
- Author:
Yongjian LIU
1
;
Minjiang CHEN
1
;
Xuefeng SUN
1
;
Chi SHAO
1
;
Yan XU
1
;
Yong CHEN
1
;
Yuanyuan ZHAO
1
;
Jing ZHAO
1
;
Mengzhao WANG
1
Author Information
1. Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing 100730, China.
- Publication Type:Journal Article
- Keywords:
Endobronchial ultrasound guided transbronchial needle aspiration;
Lung neoplasms;
Non-specific pathology
- MeSH:
Endoscopic Ultrasound-Guided Fine Needle Aspiration;
Female;
Humans;
Lung Neoplasms;
pathology;
Lymphatic Metastasis;
Male;
Mediastinum;
Middle Aged;
Retrospective Studies
- From:
Chinese Journal of Lung Cancer
2019;22(4):223-227
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) is well known as an important technique for diagnosis and staging of lung cancer. But a standard protocol to deal with patients who have a negative pathology result still needs to be defined. Herein, we describe the subsequent procedures of these patients in a single center.
METHODS:A total of 1,412 patients with clinical suspected lung cancer and mediastinal metastasis who underwent EBUS-TBNA were collected between September 2010 and December 2016. Among them, 51 patients with nonspecific pathology result were included and retrospectively analyzed.
RESULTS:The 51 patients were stratified into five groups by clinical characterize and follow-up procedures: (1) Diagnosed by other bronchoscopy procedures group (9 cases). Abnormalities of tracheobronchial tree were found during visual examination in the majority of patients (8 cases). Biopsy, endobronchial brushing, bronchoalveolar lavage, and transbronchial lung biopsy (TBLB) were used to get a specific diagnosis. (2) EBUS-TBNA re-biopsy group (11 cases). Patients in this group had normal mucosal appearance and airway lumen. Re-biopsy were performed on patients in this group. (3) Surgery group (6 cases). Patients underwent surgery after negative result of EBUS-TBNA. Five of them were confirmed with non-nodal metastasis after surgery. (4) Underwent other pathology diagnosis group (15 cases). patients in this group had other metastasis sites besides midiastinal lymph node. Computed tomography (CT)-guided fine-needle aspiration and lymph node biopsy were performed. (5) Follow-up group (10 cases). None invasive procedure was used in this group. The median follow up time was 38 months. One patient was diagnosed lymphoma during the follow up.
CONCLUSIONS:Diagnostic procedures should be chosen based on the clinical character in EBUS-TBNA negative patients with suspected lung cancer. Long time follow-up is very important in patients whose diagnosis is apparently unknown.
