Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration vs. mediastinoscopy in lung cancers and mediastinal masses

Abstract

Objective To evaluate the clinically applied value and safety between mediastinoscopy and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in patients with mediastinal masses and lung cancers. Methods The clinical data of 152 cases receiving EBUS-TBNA examination (118 cases of lung cancers and 34 cases of mediastinal masses of unknown origin), and those of 174 cases subject to mediastinoscopy examination (130 cases of lung cancers and 44 cases of mediastinal masses of unknown origin) admitted at Xuzhou Central Hospital from January 2015 to January 2017 were summarized. The diagnostic results and related indicators of two methods were compared. Results Taking pathology diagnosis as the gold standard, the accuracy, sensitivity and specificity of EBUS-TBNA and mediastinoscopy in the diagnosis and staging of lung cancers were 94.47%, 93.32% and 100.00%, and 95.98%, 94.62% and 100.00% respectively. Two techniques in the diagnosis and staging of lung cancers had no statistically significant difference (P=0.071). The accuracy, sensitivity and specificity of EBUS-TBNA and mediastinoscopy in the diagnosis of mediastinal masses were 90.79%, 58.82% and 100.00%, and 95.40%, 81.82% and 100.00% respectively. Two techniques in the diagnosis of mediastinal masses had statistically significant difference (P=0.026). Besides, as compared with mediastinoscopy, the EBUS-TBNA procedure was uneventful without complications. Conclusion EBUS-TBNA is a safe and effective method in the diagnosis and staging of lung cancers. It is expected to gradually replace mediastinoscopy as the gold standard for accurate staging of lung cancers. Key words: Lung cancer; Mediastinal lymph; Endobronchial ultrasound-guided transbronchial needle aspiration; Mediastinoscopy