Combined endobronchial and endoscopic ultrasound-guided needle aspiration performed by single ultrasound bronchoscopevs routine videobronchoscopy for diagnosis of advanced lung cancer – A prospective study

Abstract

<b>Introduction:</b> Routine videobronchofiberoscopy (VBF) using endobronchial biopsy (EBB) and conventional transbronchial needle aspiration (TBNA) is widely accepted method for diagnosis of lung cancer (LC). Endosonography including endobronchial ultrasound-guided TBNA (EBUS-TBNA), endoscopic ultrasound fine needle biopsyperformed by single ultrasound bronchoscope (EUS-b-FNA) and combined both techniques called CUS-b-NA are predominantly used for staging rather than for diagnosis of advanced LC. EBUS scope is not designed for a detailed assessment of the bronchial tree, so the examination is usually preceded by VBF. <b>Aims and objectives:</b> To establish the diagnostic yield of EBUS-TBNA and CUS-b-NA for advanced LC and to compare endosonography with routine VBF. <b>Methods:</b> In patients suspected of LC a prospective, single-center study was performed. Under conscious sedation patients underwent VBF with EBB and conventional TBNA, EBUS-TBNA or CUS-b-NA (if necessary), consecutively. <b>Results:</b> From January to December 2015, 212 patients (M:136, F:76, mean age 68) underwent VBF and EBUS-TBNA and 49 underwent CUS-b-NA. Sensitivity and accuracy of VBF vs EBUS-TBNA vs CUS-b-NA were 43% and 44.3% vs 93.7%and 93.8% vs 94.7% and 94.8%, respectively. Sensitivity and accuracy of EBUS-TBNA and CUS-b-FNA were significantly higher over routine VBF (p &lt; 0.001). <b>Conclusions:</b> Results of our study confirm that diagnostic yield of routine bronchoscopy is unsatisfactory for diagnosis of advanced LC and EBUS-TBNA or in some cases CUS-b-FNA should be commonly added to VBF.