Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies
Yıl: 2020 Cilt: 68 Sayı: 3 Sayfa Aralığı: 285 - 292 Metin Dili: İngilizce DOI: 10.5578/tt.70045 İndeks Tarihi: 09-06-2022
Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies
Öz: patients with extra-thoracic malignancies
Introduction: Endobronchial ultrasound-guided transbronchial needle aspiration
(EBUS-TBNA) is a well-established diagnostic tool for lung cancer, sarcoidosis,
and suspected metastatic extra-thoracic malignancy (ETM). Patients
with primary ETM often have hypermetabolic mediastinal/hilar lymph node
enlargement in the PET-scan done for initial staging or post treatment followup.
We aimed to determine the diagnostic performance of EBUS-TBNA and
the relationship between PET-SUV values and diagnosis of malignancy metastasis
in patients with ETM.
Materials and Methods: Results of EBUS-TBNA in ETM patients with suspected
MLN metastasis were retrospectively analysed (May 2016 to July 2019).
Non-malign results were confirmed for surgery or clinical/radiological followup.
Lymph nodes with a high FDG-uptake (SUV > 2.5, MLN) were reported
as suspicious for metastasis.
Results: Of the 588 EBUS procedures, 109 were included in the analysis.
Patient’ mean age was 62.5 ± 10.1 years; there were 35 men and 74 women.
Primary malignancies were breast cancer in 33, gastrointestinal in 23, female genital tract in 17, head and neck in 14, genitourinary cancer in 13, malignant melanoma in 6, sarcoma in 2 and kaposi sarcoma in
1. According to EBUS-TBNA smear and cell block histopathologic evaluations, 16 patients’ results (14.7%) were malignant compatible
with metastasis of ETM. Among the 93 patients with non-malignant diagnosis, EBUS-TBNA revealed a granulomatous lympadenitis
compatible with sarcoid reaction in 7 and tuberculosis in 2. A total of 9 patients underwent surgical procedures after EBUSTBNA,
with a definitive histological diagnosis of granulomatous lymphadenitis in 2, malignancy in 5 and, reactive lymph node in 2.
Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of EBUS-TBNA were
76.19% (95% CI 52.83-91.78), 100% (95% CI 95.89-100.00), 100%, 94.62% (95% CI 89.12-97.12) and 95.4%, respectively.
Conclusion: EBUS-TBNA sampling has high diagnostic performance. Histopathological confirmation requirement for MLN should be
kept in mind in patients with ETM, even they have negative EBUS results.
Anahtar Kelime: Ekstra-torasik maligniteli hastalarda EBUS-TBİA tanı değeri ve PET-BT ile ilişkisi
Öz: Giriş: Endobronşial ultrason-kılavuzluğunda transbronşial iğne aspirasyonu (EBUS-TBİA), akciğer kanseri, sarkoidoz ve metastatik
ekstra-torasik malignitelerde (ETM) iyi tanımlanmış bir tanı yöntemidir. Primer ETM evrelemesi ve tedavi sonrası takipte, mediastinal/
hiler lenf nodu (MLN) genişlemesi sık görülmektedir. ETM tanısı olan hastalarda EBUS-TBİA tanı performansı, PET-SUV değerleri ile
malign metastaz tanısı arasındaki ilişkiyi araştırmayı hedefledik.
Materyal ve Metod: Şüpheli malign metastaz olan ETM hastalarında yapılan EBUS-TBİA sonuçları retrospektif olarak analiz edildi
(Mayıs 2016-Temmuz 2019). Malign olmayan sonuçlar cerrahi veya klinik/radyolojik takip ile konfirme edildi. Yüksek FDG-uptake
olan (SUV > 2.5, MLN) lenf nodları metastaz şüpheli olarak raporlandı.
Bulgular: Toplam 588 EBUS işleminden 109'u analize dahil edildi. Hastaların ortalama yaşı 62.5 ± 10.1; 35'i erkek, 74'ü kadın idi.
Primer malignitelerin, 33’ü meme kanseri, 23'ü gastrointestinal, 17'si kadın genital sistem, 14'ü baş-boyun, 13’ü genitoüriner kanser,
6'sı malign melanom, 2'si sarkom ve 1'i kaposi sarkomu idi. EBUS-TBİA yayma ve hücre bloğu histopatolojik sonuçlarına göre 16
hastada (%14.7) ETM metastazı ile uyumlu malignite saptandı. Malign olmayan 93 hastadan 7'sinde sarkoid reaksiyon ile uyumlu
granülomatöz lenfadenit, 2'sinde tüberküloz, 5'inde malignite bulundu. EBUS-TBİA sonrası cerrahi ile toplam 9 hastanın 2'sinde
granülomatöz lenfadenit, 5'inde malignite ve 2’sinde reaktif lenf nodu saptandı. EBUS-TBİA için toplam duyarlılık, özgüllük, pozitif
prediktif değer, negatif prediktif değer ve tanı doğruluğu, sırasıyla %76.19 (%95 GA 52.83-91.78), %100 (%95 GA 95.89-100.00),
%100, %94.62 (%95 GA 89.12-97.12) ve %95.4 olarak saptandı.
Sonuç: EBUS-TBİA örneklemesi tanı performansı yüksek bir yöntemdir. Negatif EBUS sonuçları olsa da, MLN genişlemesi olan ETM
tanılı olgularda histopatolojik doğrulama gerekliliği akılda tutulmalıdır.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Demirdöğen E, Ursavas A, Aydin Guclu O, Acet Öztürk N, ÖZKAYA G, Karadağ M (2020). Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. , 285 - 292. 10.5578/tt.70045 |
| Chicago | Demirdöğen Ezgi,Ursavas Ahmet,Aydin Guclu Ozge,Acet Öztürk Nilüfer Aylin,ÖZKAYA GÜVEN,Karadağ Mehmet Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. (2020): 285 - 292. 10.5578/tt.70045 |
| MLA | Demirdöğen Ezgi,Ursavas Ahmet,Aydin Guclu Ozge,Acet Öztürk Nilüfer Aylin,ÖZKAYA GÜVEN,Karadağ Mehmet Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. , 2020, ss.285 - 292. 10.5578/tt.70045 |
| AMA | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. . 2020; 285 - 292. 10.5578/tt.70045 |
| Vancouver | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. . 2020; 285 - 292. 10.5578/tt.70045 |
| IEEE | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M "Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies." , ss.285 - 292, 2020. 10.5578/tt.70045 |
| ISNAD | Demirdöğen, Ezgi vd. "Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies". (2020), 285-292. https://doi.org/10.5578/tt.70045 |
| APA | Demirdöğen E, Ursavas A, Aydin Guclu O, Acet Öztürk N, ÖZKAYA G, Karadağ M (2020). Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tüberküloz ve Toraks, 68(3), 285 - 292. 10.5578/tt.70045 |
| Chicago | Demirdöğen Ezgi,Ursavas Ahmet,Aydin Guclu Ozge,Acet Öztürk Nilüfer Aylin,ÖZKAYA GÜVEN,Karadağ Mehmet Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tüberküloz ve Toraks 68, no.3 (2020): 285 - 292. 10.5578/tt.70045 |
| MLA | Demirdöğen Ezgi,Ursavas Ahmet,Aydin Guclu Ozge,Acet Öztürk Nilüfer Aylin,ÖZKAYA GÜVEN,Karadağ Mehmet Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tüberküloz ve Toraks, vol.68, no.3, 2020, ss.285 - 292. 10.5578/tt.70045 |
| AMA | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tüberküloz ve Toraks. 2020; 68(3): 285 - 292. 10.5578/tt.70045 |
| Vancouver | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tüberküloz ve Toraks. 2020; 68(3): 285 - 292. 10.5578/tt.70045 |
| IEEE | Demirdöğen E,Ursavas A,Aydin Guclu O,Acet Öztürk N,ÖZKAYA G,Karadağ M "Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies." Tüberküloz ve Toraks, 68, ss.285 - 292, 2020. 10.5578/tt.70045 |
| ISNAD | Demirdöğen, Ezgi vd. "Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies". Tüberküloz ve Toraks 68/3 (2020), 285-292. https://doi.org/10.5578/tt.70045 |
