title: Evaluation of performance of EUS-FNA in preoperative lymph node staging of cancers of esophagus, lung, and pancreas.
abstract: We reviewed the cytologic and histologic diagnoses and EUS report of 77 consecutive patients who had undergone EUS-FNA preoperative staging for esophageal, lung, and pancreatic cancers at our institution. A total of 122 EUS-FNA lymph nodes were identified. Thirty of 77 cases had histologic follow-up. Using surgical node staging and/or surgical resection as the reference standard, the sensitivity, specificity, accuracy, and positive and negative predictive values were 75%, 95%, 89%, 86%, and 90%, respectively, for EUS-FNA node staging. We compared cytologically malignant and benign lymph node groups with eight EUS parameters including the total number of lymph nodes found by EUS, the shape, margin, long axis, short axis, echogenicity, location of the lymph node, and EUS tumor staging. We found that the short axis is the best EUS feature to predict malignancy. Lymph nodes found in an abdominal location in esophageal and lung cancer are likely malignant.
authors.affiliation: Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA. hpeng@umm.edu
authors.forename: H Q
authors.initials: HQ
authors.lastname: Peng
authors.forename: B D
authors.initials: BD
authors.lastname: Greenwald
authors.forename: F R
authors.initials: FR
authors.lastname: Tavora
authors.forename: E
authors.initials: E
authors.lastname: Kling
authors.forename: P
authors.initials: P
authors.lastname: Darwin
authors.forename: W H
authors.initials: WH
authors.lastname: Rodgers
authors.forename: A
authors.initials: A
authors.lastname: Berry
mesh_terms: D044963:Biopsy, Fine-Needle / Q000379:methods; D019160:Endosonography; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology* / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care