Utility of ultrasound-guided supraclavicular lymph node biopsy in patients with non-small cell lung cancer

Abstract

Objective To investigate the value of ultrasound-guided supraclavicular lymph nodes biopsy in the staging of non-small cell lung cancer (NSCLC) patients. Methods The present study was a retrospective review of patients with NSCLC who underwent ultrasound-guided supraclavicular lymph node biopsy from 2005 January to 2014 February. The sensitivity, specificity, negative predictive value, positive predictive value and accuracy of ultrasound–guided supraclavicular lymph node biopsy are reported. The sizes of the lymph nodes which were biopsied and the number of instances in which treatment was changed were also reported. Results A total of 586 patients underwent ultrasound-guided supraclavicular lymph node biopsy. Of the 586 patients, 543 (92.66%) had malignant findings, 30 (5.12%) had benign findings; 11 of whom were suspected to be malignant and underwent another ultrasound-guided biopsy or incisional biopsy and 2 of them had malignant findings. Thirteen of 586 had nondiagnostic biopsy findings. As a result, ultrasound-guided supraclavicular lymph node biopsy changed the tumor stage and treatment planning in 34 (5.8%) of the 586 patients. Overall, ultrasound-guided supraclavicular lymph node biopsy had a sensitivity of 99.63%, a specificity of 100%, a negative predictive value of 93.33%, a positive predictive value of 100% and an accuracy of 97.44%. No complications were found in the patients who underwent ultrasound-guided supraclavicular lymph nodes biopsy. Conclusions Ultrasound-guided supraclavicular lymph nodes biopsy was a safe and efficient option for patients with NSCLC which had suspicious supraclavicular lymph node, and also could be used as a reliable method for clinical staging of patients with NSCLC. Key words: Ultrasound-guided biopsy; Supraclavicular lymph node; Non-small cell lung cancer; staging