title: Endobronchial ultrasound-guided transbronchial biopsy with or without a guide sheath for diagnosis of lung cancer.
abstract: BACKGROUND
  Endobronchial ultrasound-guided transbronchial biopsy with a guide sheath (EBUS-GS) is widely used for diagnosing lung cancers; however, the diagnostic yield varies widely. This study aimed to assess the efficiency of EBUS-GS.
  
  
  METHODS
  We retrospectively evaluated the results of 110 patients who underwent transbronchial biopsy (TBB) for diagnosis of peripheral lung cancer. Bronchoscopy with and without EBUS-GS was performed in 60 (group A) and 50 patients (group B), respectively; their medical records were examined, and results from the two groups were compared by using the unpaired Student t-test.
  
  
  RESULTS
  The diagnostic sensitivity for lung cancer was 83.3% in group A and 68% in group B (P=0.066) while using at least one of the following procedures: TBB, cytological brushing, and bronchial washing. The diagnostic sensitivity for lesions ≥20mm was 86.4% in group A and 76.7% in group B (P=0.263). Moreover, the diagnostic sensitivity for lesions 10-20mm was 60% in group A and 14.2% in group B (P=0.0004); the diagnostic sensitivity with TBB alone was 63.3% in group A and 44% in group B (P=0.043). The diagnostic sensitivity with TBB alone for lesions ≥20mm was 70.2% in group A and 44.8% in group B (P=0.051). Moreover, the diagnostic sensitivity for lesions 10-20mm in size was 45% in group A and 14.2% in group B with TBB alone (P=0.115).
  
  
  CONCLUSIONS
  EBUS-GS with TBB, brushing, and bronchial washing is effective in diagnosing lung cancers sized <20mm.
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: d-minami@bj8.so-net.ne.jp.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Minami
authors.affiliation: Department of General Internal Medicine 4, Kawasaki Medical School, 2-1-80 Nakasange, Okayama 700-8505, Japan. Electronic address: ntakigaw@gmail.com.
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: dai.k612@gmail.com.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Morichika
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: t-kubo@cc.okayama-u.ac.jp.
authors.forename: Toshio
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: kadoaki@gmail.com.
authors.forename: Kadoaki
authors.initials: K
authors.lastname: Ohashi
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: ahisamoto@md.okayama-u.ac.jp.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sato
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: khotta@md.okayama-u.ac.jp.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Hotta
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: tabata@md.okayama-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tabata
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: tanimoto@md.okayama-u.ac.jp.
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.affiliation: Department of Respiratory Medicine, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan. Electronic address: kkiura@md.okayama-u.ac.jp.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001980:Bronchi / Q000000981:diagnostic imaging / Q000473:pathology; D019160:Endosonography / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000295:instrumentation* / Q000379:methods; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Bronchoscopy; Endobronchial ultrasound-guided transbronchial biopsy; Guide sheath; Lung cancer