Author of

• 11856

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  P2.17 - Poster Session 2 - Bronchoscopy, Endoscopy (ID 183)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Pulmonology + Endoscopy/Pulmonary
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11863

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    P2.17-007 - Misclassification of mediastinal lymph nodes by endobronchial ultrasound (EBUS) (ID 2478)

    09:30 - 09:30  |  Author(s): C.S. Leem
    • Abstract

    Background
    Endobronchial ultrasound-guided transbronchial aspiration(EBUS-TBNA) is reported to show relatively high sensitivity and specificity in mediastinal node staging of non-small cell lung cancer (NSCLC). But discrepancies exist between bronchoscopic, radiologic, and surgical classification of mediastinal lymph nodes and thus can lead to misclassification. However, the impact of the misclassification on diagnostic performance of EBUS-TBNA has never been evaluated.

    Methods
    Medical records of NSCLC patients who underwent surgery after EBUS-TBNA for mediastinal staging from November 2010 until March 2013 in a tertiary hospital were reviewed. Of those, only lymph nodes which have been aspirated by EBUS-TBNA and removed by surgery were analyzed. Patients who received neoadjuvant chemotherapy between EBUS-TBNA and surgery were excluded. Detailed review of medical records and radiological imaging was done to infer the causes for false negative or positive results.

    Results
    A total of 105 lymph nodes from 96 patients were included in our analysis. Median interval between EUB-TBNA and surgery was 11 days. A total of 8 lymph nodes(7.6%) showed false negative results and only one lymph node (0.9%) showed false positive result. Sensitivity, specificity, accuracy, positive and negative predictive value (PPV and NPV) of EBUS-TBNA for malignancy were 65.2%, 97.5%, 88.5%, 88.5%, 90.6%, respectively. After detailed review of cases who had false positive or negative results, 3 false negative lymph nodes and 1 false positive lymph node (44%) were recognized to be due to misclassification. Other false negative cases were due to sampling errors.

    Conclusion
    Misclassification of lymph nodes can cause false positive or false negative results of EBUS-TBNA.