title: Clinical value of detection of metastasis of carina in patients with non-small cell lung cancer.
abstract: BACKGROUND
  Although the utility of blind biopsy in the detection of metastasis in the carina has been reported, submucosal fine needle aspiration (SMFNA) has not been evaluated. We investigated how SMFNA of the main carina and upper-lobe carina in addition to blind biopsy affect management of patients with NSCLC.
  
  
  METHODS
  Thirty-five patients were evaluated. During fiberoptic bronchoscopy (FOB), five blind biopsy and three SMFNA specimens were collected from normal-appearing main carina (n = 35) and/or upper-lobe carina (n = 18). Subjects were staged for operability using traditional staging system, without knowing the blind biopsy or SMFNA results. Then, patients were staged again after results were made known.
  
  
  RESULTS
  Thirty-five NSCLC patients were analyzed. The management of 12 patients (34%) was changed according to our results. Out of the patients, 8, 5 and one had microscopic metastasis in the main carina, ipsilateral upper-lobe carina and both, respectively. Although SMFNA were more diagnostic compared to blind forceps biopsy, there was no statistically difference between them. These procedures increased the success of detection of microscopic metastasis and the results changed management of those cases.
  
  
  CONCLUSIONS
  SMFNA adds valuable information to blind biopsy, and their combination changed the management in one quarter of our NSCLC patients.
authors.affiliation: Department of Pulmonary Medicine, Ataturk University, Erzurum, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Kaynar
authors.forename: Mehmet
authors.initials: M
authors.lastname: Meral
authors.forename: Elif Yilmazel
authors.initials: EY
authors.lastname: Ucar
authors.forename: Leyla
authors.initials: L
authors.lastname: Saglam
authors.forename: Umran
authors.initials: U
authors.lastname: Yildirim
authors.forename: Metin
authors.initials: M
authors.lastname: Gorguner
authors.forename: Metin
authors.initials: M
authors.lastname: Akgun
mesh_terms: D044963:Biopsy, Fine-Needle; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D013147:Spirometry; D014134:Tracheal Neoplasms / Q000473:pathology / Q000556:secondary*