José Sanz-Santos1, Mireia Serra2, Miguel Gallego3, Concepción Montón4, Borja Cosio5, Jaume Sauleda6, Alberto Fernández-Villar7, Ricardo García-Luján8, Eduardo de Miguel8, Rosa Cordovilla9, Gonzalo Varela9, Enrique Cases10, Felipe Andreo11, Eduard Monsó12. 1. Hospital Universitari Germans Trias i Pujol, Badalona, Spain 34057jss@comb.cat. 2. Hospital Universitari del Parc Taulí, Sabadell, Spain Departament de Medicina, Universitat Autónoma de Barcelona, Bellaterra, Spain. 3. Hospital Universitari del Parc Taulí, Sabadell, Spain Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain. 4. Hospital Universitari del Parc Taulí, Sabadell, Spain. 5. Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain Hospital Universitari Son Espases, Palma de Mallorca, Spain. 6. Hospital Universitari Son Espases, Palma de Mallorca, Spain Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain Institut Universitari de Ciències de la Salut, Palma de Mallorca, Spain. 7. Complexo Hospitalario Universitario de Vigo, Vigo, Spain. 8. Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain Hospital Universitario 12 de Octubre, Madrid, Spain. 9. Complejo Asistencial de Salamanca, Salamanca, Spain. 10. Hospital Universitari La Fe, Valencia, Spain. 11. Hospital Universitari Germans Trias i Pujol, Badalona, Spain Departament de Medicina, Universitat Autónoma de Barcelona, Bellaterra, Spain Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain. 12. Hospital Universitari del Parc Taulí, Sabadell, Spain Departament de Medicina, Universitat Autónoma de Barcelona, Bellaterra, Spain Ciber de Enfermedades Respiratorias-Ciberes, Bunyola, Spain.
Abstract
OBJECTIVES: False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging have shown significant variability in previous studies. The aim of this study was to identify procedure- and tumour-related determinants of endobronchial ultrasound-guided transbronchial needle aspiration false-negative results. METHODS: We conducted a prospective study that included non-small-cell lung cancer patients staged as N0/N1 by endobronchial ultrasound-guided transbronchial needle aspiration and undergoing therapeutic surgery. The frequency of false-negative results in the mediastinum was calculated. Procedure-related, first, and tumour-related, second, determinants of false-negative results in stations reachable and non-reachable by endobronchial ultrasound were determined by multivariate logistic regression. RESULTS: False-negative endobronchial ultrasound-guided transbronchial needle aspiration results were identified in 23 of 165 enrolled patients (13.9%), mainly in stations reachable by endobronchial ultrasound (17 cases, 10.3%). False-negative results were related to the extensiveness of endobronchial ultrasound sampling: their prevalence was low (2.4%) when sampling of three mediastinal stations was satisfactory, but rose above 10% when this requirement was not fulfilled (P = 0.043). In the multivariate analysis, abnormal mediastinum on computer tomography/positron emission tomography [odds ratio (OR) 7.77, 95% confidence interval (CI) 2.19-27.51, P = 0.001] and extensiveness of satisfactory sampling of mediastinal stations (OR 0.37, 95% CI 0.16-0.89, P = 0.026) were statistically significant risk factors for false-negative results in stations reachable by endobronchial ultrasound. False-negative results in non-reachable nodes were associated with a left-sided location of the tumour (OR 10.11, 95% CI 1.17-87.52, P = 0.036). CONCLUSIONS: The presence of false-negative ultrasound-guided transbronchial needle aspiration results were observed in nearly 15% of non-small-cell lung cancer patients but in only 3% when satisfactory samples were obtained from three mediastinal stations. False-negative results in stations reachable by endobronchial ultrasound were associated with the extensiveness of sampling, and in stations out of reach of endobronchial ultrasound with left-sided tumours. These results suggest that satisfactory sampling of at least three mediastinal stations by EBUS-TBNA may be a quality criterion to be recommended for EBUS-TBNA staging.
OBJECTIVES: False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging have shown significant variability in previous studies. The aim of this study was to identify procedure- and tumour-related determinants of endobronchial ultrasound-guided transbronchial needle aspiration false-negative results. METHODS: We conducted a prospective study that included non-small-cell lung cancerpatients staged as N0/N1 by endobronchial ultrasound-guided transbronchial needle aspiration and undergoing therapeutic surgery. The frequency of false-negative results in the mediastinum was calculated. Procedure-related, first, and tumour-related, second, determinants of false-negative results in stations reachable and non-reachable by endobronchial ultrasound were determined by multivariate logistic regression. RESULTS: False-negative endobronchial ultrasound-guided transbronchial needle aspiration results were identified in 23 of 165 enrolled patients (13.9%), mainly in stations reachable by endobronchial ultrasound (17 cases, 10.3%). False-negative results were related to the extensiveness of endobronchial ultrasound sampling: their prevalence was low (2.4%) when sampling of three mediastinal stations was satisfactory, but rose above 10% when this requirement was not fulfilled (P = 0.043). In the multivariate analysis, abnormal mediastinum on computer tomography/positron emission tomography [odds ratio (OR) 7.77, 95% confidence interval (CI) 2.19-27.51, P = 0.001] and extensiveness of satisfactory sampling of mediastinal stations (OR 0.37, 95% CI 0.16-0.89, P = 0.026) were statistically significant risk factors for false-negative results in stations reachable by endobronchial ultrasound. False-negative results in non-reachable nodes were associated with a left-sided location of the tumour (OR 10.11, 95% CI 1.17-87.52, P = 0.036). CONCLUSIONS: The presence of false-negative ultrasound-guided transbronchial needle aspiration results were observed in nearly 15% of non-small-cell lung cancerpatients but in only 3% when satisfactory samples were obtained from three mediastinal stations. False-negative results in stations reachable by endobronchial ultrasound were associated with the extensiveness of sampling, and in stations out of reach of endobronchial ultrasound with left-sided tumours. These results suggest that satisfactory sampling of at least three mediastinal stations by EBUS-TBNA may be a quality criterion to be recommended for EBUS-TBNA staging.
Authors: Laura Millares; Mireia Serra; Felipe Andreo; Jose Sanz-Santos; Concepción Montón; Carles Grimau; Miguel Gallego; Laia Setó; Neus Combalia; Mariona Llatjos; Rosa Escoda; Eva Castellà; Eduard Monsó Journal: Clin Exp Metastasis Date: 2015-06-29 Impact factor: 5.150
Authors: Maja Guberina; Kaid Darwiche; Hubertus Hautzel; Till Ploenes; Christoph Pöttgen; Nika Guberina; Ken Herrmann; Lale Umutlu; Axel Wetter; Dirk Theegarten; Clemens Aigner; Wilfried Ernst Erich Eberhardt; Martin Schuler; Rüdiger Karpf-Wissel; Martin Stuschke Journal: Eur J Nucl Med Mol Imaging Date: 2021-02-05 Impact factor: 9.236
Authors: M Serra Fortuny; M Gallego; Ll Berna; C Montón; L Vigil; M J Masdeu; A Fernández-Villar; M I Botana; R Cordovilla; R García-Luján; E Cases; E Monsó Journal: BMC Pulm Med Date: 2016-12-08 Impact factor: 3.317
Authors: Virginia Leiro; Loretta De Chiara; Mar Rodríguez-Girondo; Maribel Botana-Rial; Diana Valverde; Manuel Núñez-Delgado; Alberto Fernández-Villar Journal: Cancers (Basel) Date: 2019-09-20 Impact factor: 6.639
Authors: Rosa Cordovilla; Marco López-Zubizarreta; Antonio Velasco; Alberto Álvarez; Marta Rodríguez; Asunción Gómez; Miguel Ángel Hernández-Mezquita; Miguel Iglesias Journal: Biomed Hub Date: 2021-10-08