Learning curve for endobronchial ultrasound‑guided transbronchial needle aspiration: Experience of a community‑based teaching hospital

  • Authors:
    • He Wang
    • Cyril D'Cruz
    • David C. Yam
    • Lorie M. Dilla
    • Patricia Tsang
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  • Published online on: September 3, 2014     https://doi.org/10.3892/mmr.2014.2533
  • Pages: 2441-2446
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Abstract

Endobronchial ultrasound‑guided transbronchial needle aspiration (EBUS‑TBNA) is a minimally invasive procedure. This procedure is useful for nodal staging of lung cancer and evaluating mediastinal lymphoma and granuloma. The present study was a retrospective analysis of our experience when EBUS‑TBNA was initially implemented. A total of 112 lymph nodes/masses (51 patients) were divided into two groups: The first and second 8 months. In the first group, 33 lymph nodes/masses (16 patients) were biopsied and tumor diagnoses were made in 9% of the cases (three lymph nodes/masses). The material was adequate to produce a cell block for microscopic analysis in 42% of cases. Subsequent tissue diagnoses were available in 50% of cases. Only one of the three malignant EBUS‑TBNA diagnoses (33%) was confirmed by histological examination. In the second 8 months, 79 lymph nodes (35 patients) were sampled. Tumor/granuloma diagnoses were achieved in 27% of the cases (21 nodes) (P=0.045 versus the first 8 months) and the obtained material was adequate for producing a cell block in 90% of cases (P<0.001 versus the first 8 months). Corresponding tissue diagnoses were available in 28% of cases. Correlation of EBUS-TBNA and histological examination for tumor/granuloma diagnosis was 100% (12/12, P=0.029 versus the first 8 months). Immunostains in the cell blocks indicated that all the metastatic adenocarcinomas were thyroid transcription factor‑1 (TTF‑1)+ and p63‑, and that all squamous cell carcinomas were TTF‑1‑, p63+ and cytokeratin 5/6 (CK5/6)+. Eight granulomata were identified, of which five were positive for Acid‑Fast Bacilli (AFB) stain and confirmed by culture or tissue biopsy. The remaining three granulomata were AFB‑negative. EGFR/KRAS mutation analysis was conducted in cell blocks of five adenocarcinomas, of which all provided sufficient diagnostic material. The findings showed a steep learning curve when EBUS‑TBNA was first adopted, reflected by an increased rate of tumor/granuloma diagnoses as well as an improved sample yield for cell block preparation in the second 8 months. TTF‑1, p63 and CK5/6 were useful biomarkers for distinguishing metastatic lung carcinomas.
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November-2014
Volume 10 Issue 5

Print ISSN: 1791-2997
Online ISSN:1791-3004

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Spandidos Publications style
Wang H, D'Cruz C, Yam DC, Dilla LM and Tsang P: Learning curve for endobronchial ultrasound‑guided transbronchial needle aspiration: Experience of a community‑based teaching hospital. Mol Med Rep 10: 2441-2446, 2014
APA
Wang, H., D'Cruz, C., Yam, D.C., Dilla, L.M., & Tsang, P. (2014). Learning curve for endobronchial ultrasound‑guided transbronchial needle aspiration: Experience of a community‑based teaching hospital. Molecular Medicine Reports, 10, 2441-2446. https://doi.org/10.3892/mmr.2014.2533
MLA
Wang, H., D'Cruz, C., Yam, D. C., Dilla, L. M., Tsang, P."Learning curve for endobronchial ultrasound‑guided transbronchial needle aspiration: Experience of a community‑based teaching hospital". Molecular Medicine Reports 10.5 (2014): 2441-2446.
Chicago
Wang, H., D'Cruz, C., Yam, D. C., Dilla, L. M., Tsang, P."Learning curve for endobronchial ultrasound‑guided transbronchial needle aspiration: Experience of a community‑based teaching hospital". Molecular Medicine Reports 10, no. 5 (2014): 2441-2446. https://doi.org/10.3892/mmr.2014.2533