Endobronchial ultrasound-guided transbronchial needle aspiration for lung cancer staging: early experience in Brazil.
OBJECTIVE
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive, safe and accurate method for collecting samples from mediastinal and hilar lymph nodes. This study focused on the initial results obtained with EBUS-TBNA for lung cancer and lymph node staging at three teaching hospitals in Brazil.


METHODS
This was a retrospective analysis of patients diagnosed with lung cancer and submitted to EBUS-TBNA for mediastinal lymph node staging. The EBUS-TBNA procedures, which involved the use of an EBUS scope, an ultrasound processor, and a compatible, disposable 22 G needle, were performed while the patients were under general anesthesia.


RESULTS
Between January of 2011 and January of 2014, 149 patients underwent EBUS-TBNA for lymph node staging. The mean age was 66 ± 12 years, and 58% were male. A total of 407 lymph nodes were sampled by EBUS-TBNA. The most common types of lung neoplasm were adenocarcinoma (in 67%) and squamous cell carcinoma (in 24%). For lung cancer staging, EBUS-TBNA was found to have a sensitivity of 96%, a specificity of 100%, and a negative predictive value of 85%.


CONCLUSIONS
We found EBUS-TBNA to be a safe and accurate method for lymph node staging in lung cancer patients.
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Viviane Rossi
VR
Figueiredo
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Paulo Francisco Guerreiro
PF
Cardoso
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Márcia
M
Jacomelli
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Bronchoscopy Department. Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Sérgio Eduardo
SE
Demarzo
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Bronchoscopy Department. Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Addy Lidvina Mejia
AL
Palomino
University of São Paulo, School of Medicine, Hospital das Clínicas, São Paulo, Brazil. Bronchoscopy Department. Heart Institute of the University of São Paulo School of Medicine Hospital das Clínicas, São Paulo, Brazil.
Ascédio José
AJ
Rodrigues
University of São Paulo, School of Medicine, Department of Cardiorespiratory Diseases, São Paulo, Brazil. Department of Cardiorespiratory Diseases, University of São Paulo School of Medicine, São Paulo, Brazil.
Ricardo Mingarini
RM
Terra
University of São Paulo, School of Medicine, Department of Cardiorespiratory Diseases, São Paulo, Brazil. Thoracic Surgery Section, Department of Cardiorespiratory Diseases, University of São Paulo School of Medicine, São Paulo, Brazil.
Paulo Manoel
PM
Pego-Fernandes
University of São Paulo, School of Medicine, Department of Cardiorespiratory Diseases, São Paulo, Brazil. Pulmonology Section, Department of Cardiorespiratory Diseases, University of São Paulo School of Medicine, São Paulo, Brazil.
Carlos Roberto Ribeiro
CR
Carvalho
D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods*; D001938:Brazil; D001999:Bronchoscopy / Q000379:methods*; D003430:Cross-Sectional Studies; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D012680:Sensitivity and Specificity
Bronchoscopy; Endoscopic ultrasound-guided fine needle aspiration; Lung neoplasms; Lymph nodes; Neoplasm staging