Early Experience of Real Time Endobronchial Ultrasound-Guided Fine Needle Aspiration for the Diagnosis of Mediastinal Lymph Node Metastasis in Lung Cancer Patients

Abstract

Background/purpose. The correct evaluation of mediastinal/hilar lymph node metastasis allows appropriate therapy for patients with lung cancer. We applied real time endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA) to patients with lung cancer for pathological diagnosis of mediastinal/hilar lymph node metastasis. The aim of the present report is to retrospectively evaluate early results of EBUS-FNA. Method. We conducted a retrospective review of 19 patients with lung cancer who underwent EBUS-FNA for mediastinal/hilar lymph nodes between March 2003 and January 2004. Results. No patients developed serious complications during or after EBUS-FNA. Of 19 patients, 8 were positive, 11 were negative for malignant cells. Sixteen patients underwent subsequent mediastinoscopy or surgical therapy. The results of EBUS-FNAS for 22 lymph nodes in these 16 patients were compared with the final surgical result, and the diagnostic accuracies were calculated. The sensitivity for the pretracheal lymph node (# 3 lymph node) was 25%, whereas the sensitivities for other lymph node levels were all 100%. The total sensitivity and specificity of EBUS-FNA are 73% and 100%, respectively. Conclusion. We were safely able to perform EBUS-FNA for mediastinal/hilar lymph nodes with satisfactory diagnostic accuracies. However, we need some technical improvement in the application of EBUS-FNA to #3 lymph node.