title: Diagnostic utility of endobronchial ultrasound guided transbronchial needle aspiration for mediastinal lesions: A prospective three year, single centre analysis.
abstract: BACKGROUND
  The diagnostic yield of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) over a 3-year period was analyzed.
  
  
  METHODS
  Consecutive patients who underwent EBUS for the evaluation of pulmonary/mediastinal lesions were recruited.
  
  
  RESULTS
  One hundred and ninety-one patients were studied (54% male, mean age, 65 years [standard deviation 11.1]). A final diagnosis of a malignant disorder was made in 151 patients (79%). Of these, EBUS-TBNA alone provided the diagnosis in 135 patients. The majority of the remaining 56 patients had reactive changes (n = 32). Nineteen patients, either because they did not respond to appropriate treatment or based on clinical indication, underwent a different procedure resulting in an additional diagnosis of malignancy in 16 patients, tuberculosis in one and indeterminate in two. The diagnostic yield of EBUS for malignant disorders was 70.7% (95% confidence interval (CI), 0.86, 0. 77). The overall ability of EBUS to achieve a definitive diagnosis (benign plus malignant) was 90.1% (95% CI, 0.85, 0. 94). Logistic regression and stepwise regression analysis revealed that older age, greater lymph node size, and the presence of intraprocedure complications significantly influenced EBUS yield for malignancy.
  
  
  CONCLUSIONS
  EBUS-TBNA has a high diagnostic yield for mediastinal lesions, both benign and malignant. The yield depends on both lesion- and patient-related factors.
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Respiratory Medicine, Royal Preston Hospital, Preston, UKDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Anant
authors.initials: A
authors.lastname: Mohan
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Respiratory Medicine, Royal Preston Hospital, Preston, UKDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Samir
authors.initials: S
authors.lastname: Naik
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Respiratory Medicine, Royal Preston Hospital, Preston, UKDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Ravinder Mohan
authors.initials: RM
authors.lastname: Pandey
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Respiratory Medicine, Royal Preston Hospital, Preston, UKDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Janet
authors.initials: J
authors.lastname: Mills
authors.affiliation: Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Respiratory Medicine, Royal Preston Hospital, Preston, UKDepartment of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Munavvar
keywords: Endobronchial ultrasound; lung cancer; transbronchial needle aspiration