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Title: The assessment of efficacy of transbronchial needle aspiration of peripheral lung lesions controlled by endobronchial ultrasound mini probe
Abstract:
Objectives The aim of this study was to establish a diagnostic yield of mini-probe EBUS guided TBNA followed by EBBB and to asses safety profile of this method. Materials and methods Consecutive patients who needed cytological evaluation of peripheral lung lesion visible in chest X-ray and/or chest CT were included into this prospective open trial after PET-CT scan. After detailed analysis of CT scans selected bronchi were examined with mini-probe EBUS. In case of no malignancy found in obtained tissue material patients were scheduled for further invasive diagnostics or for six month pulmonological follow up. Results 115 patients underwent mini-probe EBUS examination. 64.3% (n=74) male and 35.7% (n=41) female in age 31-85 (mean 67.57 years; median 68 years). The size of the lesion measured in CT was 12-42mm (mean 22.36mm; median 22mm; SD ±6.64mm). 8 patients were lost to follow up. Results obtained in 107 patients were analyzed. The detection ratio of the lesion in this group was 89.7%. Malignancy was found in 49 cases (one result was false positive) and no suspected for malignancy cells were found in 58 cases (18 results were false negative). Considering ultrasonograpic detection ratio sensitivity, specificity, total accuracy, NPV and PPV of this diagnostic method were: 0.73; 0.98; 0.82; 0.69 and 0.98 respectively.Statistical analysis of the biopsy results revealed higher diag ; nostic yield of combined biopsy method (TBNA followed with EBBB) but improvement was statistically non-significant (for sensitivity, accuracy and NPV P=0.16).No relevant complications were observed. Conclusions Mini-probe EBUS guided biopsy is valuable tool in diagnosis of peripheral lung lesions. Its yield is comparable with TBLB, and seems to be safer considering risk of pneumothorax. Performing EBBB after a needle biopsy should be limited to selected cases of peribronchial lesions. Presented diagnostic method allowed to reduce in easy and safe way necessity of more invasive and more risky diagnostic procedures in ca. 45% of patients.
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Last modified:
Jun 26, 2023
In our library since:
May 6, 2019
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232
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http://dl.cm-uj.krakow.pl:8080/publication/4278
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| Edition name | Date |
|---|---|
| ZB-128093 | Jun 26, 2023 |
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