[Value of transbronchial needle aspiration in the diagnosis of endobronchial malignant lesions].
Aim of our study was to investigate the sensitivity of transbronchial needle aspiration (TBNA) and its contributions to conventional diagnostic methods (CDM) in the endobronchial lesions of the patients who underwent TBNA during fiberoptic bronchoscopy (FOB) and had final diagnosis of lung cancer. Bronchoscopy records of 1194 patients, who underwent FOB for uncertain lung cancer in our clinic, were reviewed retrospectively. Eighty-one patients with final histopathological diagnosis of primary lung cancer who underwent TBNA, were included to study. Endobronchial lesions were divided into three groups as endobronchial mass, submucosal lesions and peribronchial diseases. Other CDMs performed during bronchoscopy such as forceps biopsy, bronchial brushing and bronchial lavage were also recorded. Sixty-six (82%) of 81 patients were diagnosed by means of FOB. Remaining 15 (18%) patients were diagnosed by means of other methods than FOB. The diagnostic successes of TBNA and CDMs alone and together, were compared according to the types, locations and histopathological types of the lesions. By the addition of TBNA to CDMs, histopathological diagnosis was made in 17 (21%) additional patients and diagnostic sensitivity of bronchoscopy was increased from 60% to 82% (p= 0.001). By the addition of TBNA to CDMs, a statistically significant increase in the sensitivity in the submucosal lesion group was observed (p= 0.008). By the addition of TBNA to CDMs, diagnostic success was increased from 52% to 76% in the non-small cell lung cancer group and from 81% to 95% in the small cell lung cancer group (p= 0.001 and p= 0.250, respectively). Although the diagnostic success was increased in all localizations by the addition of TBNA to CDMs, statistically significant increase was observed only for the lesions located at trachea and the main bronchi (p= 0.008). Joining TBNA to CDMs, especially for the submucosal lesions, may improve the diagnostic success of bronchoscopy.
Uskül
Bahadir Taha
BT
Süreyyapaşa Thoracic and Cardiovascular Diseases Training and Research Hospital, Istanbul, Turkey. tbuskul@yahoo.com
Türker
Hatice
H
Melikoğlu
Alkin
A
Yilmaz
Adnan
A
Boğa
Sibel
S
Ulman
Can
C
D044963:Biopsy, Fine-Needle; D001980:Bronchi / Q000473:pathology; D018893:Bronchoalveolar Lavage; D001999:Bronchoscopy; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology*; D018288:Carcinoma, Small Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity