A comparison of the diagnostic value of 19-gauge histology and 22-gauge cytology needles in bronchoscopy for the evaluation of endobronchial lesions

Abstract

To prospectively compare the sensitivity of Wang 22-gauge needle aspiration and 19-gauge needle aspiration with bronchial biopsy and determine whether there was difference between 22-gauge and 19-gauge needle aspirations in the diagnosis of endobronchial malignancies. Materials and methods: All patients (63 patients) in the study underwent fiberoptic bronchoscopy that included 22-gauge needle aspiration and 19-gauge needle aspiration. In 50 patients bronchial biopsy was done. The sensitivities of the individual techniques were compared. Results: Cancer was diagnosed in 48 patients by 22-gauge needle aspiration and 19-gauge needle aspiration, and in 43 patients by bronchial biopsy. The sensitivity of bronchial biopsy was 0.86. The addition of 22-gauge and 19-gauge needle aspirations to bronchial biopsy increased the sensitivity to 0.90 and 0.88, respectively, but the difference was not statistically significant (P = 1.0). The maximal diagnostic yield was obtained with the combination of needle aspirations and forceps biopsy in the detection of submucosal or peribronchial bronchogenic carcinoma (100%) (P < 0.05). Conclusion: The combination of forceps biopsy and transbronchial needle aspirations should be used for the highest rate of bronchoscopic diagnostic yield. However, there was no difference for increasing diagnostic yield in patients with visible endobronchial lesions between 22-gauge and 19- gauge needles.