title: Learning curve of conventional transbronchial needle aspiration.
abstract: OBJECTIVE
  Intrathoracic lymphadenopathy usually occurs as a result of neoplasm, granulomatous diseases, infections or reactive hyperplasia. Conventional transbronchial needle aspiration (C-TBNA) is a cheap and safe procedure for diagnosing intrathoracic lymphadenopathy. The aim of this study was to assess the learning curve and diagnostic accuracy of C-TBNA after an observational education programme.
  
  
  METHODS
  In the present study, we retrospectively evaluated our first 62 C-TBNA procedures at Erciyes University between May 2012 and December 2012 after an observational education programme. The first 31 patients were defined as group A, and the second 31 patients as group B.
  
  
  RESULTS
  One hundred and seven lymph nodes were sampled in 62 patients by C-TBNA. Adequate lymph node samples were obtained in 52 of the 62 patients (83.8%). In these 52 patients, two patients had a diagnosis of 'suspicious of malignancy' by C-TBNA, and these patients were excluded from the analysis. In the remaining 50 cases who had adequate results, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy per patient were 80.6%, 92.9%, 96.7%, 65.0% and 84.0%, respectively. The diagnostic accuracy rates of C-TBNA for Group A and B were 72.0% (18/25) and 96.0% (24/25), and the difference was statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  C-TBNA is a useful diagnostic procedure for sampling intrathoracic lymphadenopathies and masses that are adjacent to the bronchial system. An observational education programme is helpful for learning C-TBNA. The diagnostic yield improves in time, and approximately 30 procedures may be sufficient to achieve successful results.
authors.affiliation: Department of Pulmonary Medicine, School of Medicine, Erciyes University, Kayseri, Turkey.
authors.forename: Nuri
authors.initials: N
authors.lastname: Tutar
authors.forename: Hakan
authors.initials: H
authors.lastname: Büyükoğlan
authors.forename: Insu
authors.initials: I
authors.lastname: Yılmaz
authors.forename: Asiye
authors.initials: A
authors.lastname: Kanbay
authors.forename: Omer
authors.initials: O
authors.lastname: Onal
authors.forename: Mehmet
authors.initials: M
authors.lastname: Bilgin
authors.forename: Ozlem
authors.initials: O
authors.lastname: Canöz
authors.forename: Ramazan
authors.initials: R
authors.lastname: Demir
authors.forename: Fatma Sema
authors.initials: FS
authors.lastname: Oyak
authors.forename: Inci
authors.initials: I
authors.lastname: Gülmez
authors.forename: Erdoğan
authors.initials: E
authors.lastname: Cetinkaya
mesh_terms: D001707:Biopsy, Needle / Q000379:methods*; D001999:Bronchoscopy / Q000193:education / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis; D003877:Dermatitis, Contact; D006801:Humans; D059032:Learning Curve; D008175:Lung Neoplasms / Q000175:diagnosis; D008198:Lymph Nodes / Q000473:pathology; D008206:Lymphatic Diseases / Q000175:diagnosis*; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis
keywords: bronchoscopy; learning curve; mediastinal lymphadenopathy; transbronchial aspiration