title: [Evaluation of the value of EBUS-TBNA in diagnosis of mediastinal lesions].
abstract: OBJECTIVE
  To evaluate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in diagnosis of mediastinal lesions and to discuss its optimal indication.
  
  
  METHODS
  One hundred and twenty three patients with mediastinal lesions who underwent EBUS-TBNA were included in this study. The accuracy, sensitivity, specificity, positive and negative predictive value of EBUS-TBNA in diagnosis of mediastinal lesions were analyzed according to the final diagnosis and evaluate its value and the optimal indication.
  
  
  RESULTS
  In the 123 patients, EBUS-TBNA was successfully performed to obtain samples from 286 stations of lymph nodes (2.33 stations/per patient). The puncture success rate was 100%. The procedure was uneventful without complications. Final diagnosis indicated that there were 83 positive and 40 negative patients. EBUS-TBNA had a sensitivity of 95.2%, specificity of 100%, positive predictive value of 100%, negative predictive value of 90.0%, and overall accuracy of 96.8%. For diagnosis of the epithelial cancer, EBUS-TBNA had an accuracy of 98.8%, sensitivity of 98.8%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 100%. EBUS-TBNA failed to reveal three lymphomas. For diagnosis of benign mediastinal diseases, EBUS-TBNA had a diagnosis rate of 47.2% which had a confirmed clinical application value.
  
  
  CONCLUSIONS
  EBUS-TBNA may be expected to replace the mediastinoscopy as a superior choice for diagnosis of mediastinal epithelial cancers. EBUS-TBNA can not replace mediastinoscopy but being a promising tool for diagnosis of benign mediastinal lesions including granulomas. For certain special diseases such as lymphoma, mediastinoscopy cannot be replaced. However, EBUS-TBNA can be a potentially favorite choice for early stage screening.
authors.affiliation: Department of Thoracic Surgery, Cancer Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Hu
authors.forename: Hai-quan
authors.initials: HQ
authors.lastname: Chen
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.forename: Ting
authors.initials: T
authors.lastname: Ye
authors.forename: Bo
authors.initials: B
authors.lastname: Ping
authors.forename: Fu
authors.initials: F
authors.lastname: Yang
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Zhou
authors.forename: Xiao-yang
authors.initials: XY
authors.lastname: Luo
authors.forename: Lei
authors.initials: L
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods*; D001999:Bronchoscopy; D005260:Female; D006099:Granuloma / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology*; D008481:Mediastinoscopy; D008875:Middle Aged; D011237:Predictive Value of Tests; D012507:Sarcoidosis / Q000473:pathology; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional; D055815:Young Adult