The utility of endobronchial ultrasound-guided transbronchial needle aspiration in patients with small-cell lung cancer

Abstract

Objective Most small-cell lung cancers (SCLCs) are located within the central aspect of the chest and manifest as a mediastinal or hilar lymphadenopathy. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) makes it possible to perform mediastinal and hilar nodal examinations. The purpose of this study was to evaluate the performance of EBUS-TBNA in the diagnosis of SCLC. Methods The diagnostic performances of EBUS-TBNA and/or transesophageal bronchoscopic ultrasoundguided fine-needle aspiration (EUS-FNA-B/E) were calculated using the standard definitions. Patients The study consisted of a retrospective review of the medical records for all patients with histologically proven SCLC who previously underwent EBUS-TBNA and/or EUS-FNA-B/E from May 2009 to September 2014. Results The analysis was based on 161 patients and 299 aspirated specimens. The patient group included 144 males (89%); the median age was 66 years. EBUS-TBNA and/or EUS-FNA-B/E were performed in 239 mediastinal nodes, 39 hilar/interlobar nodes, and 21 lung parenchymal lesions. The median short diameter of the biopsied lesions was 17 mm. The overall sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of EBUS-TBNA and/or EUS-FNA-B/E on a per-person basis were 97.4%, 100%, 60%, 100%, and 97.5%, respectively. The corresponding values on a per-lesion basis were 91.8%, 100%, 73.0%, 100%, and 93.3%, respectively. There were no serious complications related to EBUS-TBNA. Conclusion In our series of patients with SCLC, EBUS-TBNA had an excellent diagnostic yield in the evaluation of mediastinal, hilar and lung parenchymal lesions. Thus, EBUS-TBNA could be a useful and safe diagnostic method with which to evaluate patients with SCLC.