title: TBNA with and without EBUS: a comparative efficacy study for the diagnosis and staging of lung cancer.
abstract: BACKGROUND
  Conventional transbronchial needle aspiration (TBNA) has been around for over 30 years with sensitivities approaching 70-90%. Recent development of endobronchial ultrasound (EBUS) TBNA demonstrated even higher sensitivities among experts. However EBUS-TBNA is more costly and less available worldwide than conventional TBNA. A comparison study to determine the efficacy of TBNA with and without EBUS in the diagnosis and staging of lung cancer is described.
  
  
  METHODS
  A total of 287 patients with mediastinal and hilar lymphadenopathy presenting for diagnosis and/or staging of lung cancer at enrolling institutions were included. Equal numbers of punctures were performed at the target lymph node stations using conventional TBNA techniques followed by EBUS-TBNA at the same sites. Patients and puncture sites that were biopsied by both methods and were positive for lung cancer were compared to establish efficacy of each technique on the same patients.
  
  
  RESULTS
  In 253 patients at least one pair of specimens were obtained by conventional TBNA and EBUS-TBNA. In 83 of these patients malignancy was diagnosed. Among the 83 patients with a diagnosis of a malignancy there was no significant difference in the diagnostic yield of conventional TBNA versus EBUS-TBNA. When comparing diagnosis of malignancy for each lymph node sampled, there were a significantly greater number of positive (diagnostic for malignancy) lymph nodes sampled by EBUS-TBNA.
  
  
  CONCLUSIONS
  Recommendations for current practice depend on individual centers and bronchoscopist comfort level with TBNA (with or without EBUS). In our study, no significant difference was seen between the techniques for the diagnosis and staging of individual patients.
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Junhong
authors.initials: J
authors.lastname: Jiang
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Browning
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Noah
authors.initials: N
authors.lastname: Lechtzin
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Jianan
authors.initials: J
authors.lastname: Huang
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Terry
authors.affiliation: 1 Department of Respiratory, the First Affiliated Hospital of Soochow University, Suzhou 215006, China ; 2 Division of Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, MD, USA ; 3 Department of Pulmonary Medicine, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: Ko Pen
authors.initials: KP
authors.lastname: Wang
keywords: Bronchoscopy; endobronchial ultrasound (EBUS); lung cancer; transbronchial needle aspiration (TBNA)