Comparison of multiple techniques for endobronchial ultrasound-transbronchial needle aspiration specimen preparation in a single institution experience.

Details

Serval ID
serval:BIB_10BAD525E602
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Comparison of multiple techniques for endobronchial ultrasound-transbronchial needle aspiration specimen preparation in a single institution experience.
Journal
Journal of thoracic disease
Author(s)
Rotolo N., Cattoni M., Crosta G., Nardecchia E., Poli A., Moretti F., Conti V., La Rosa S., Dominioni L., Imperatori A.
ISSN
2072-1439 (Print)
ISSN-L
2072-1439
Publication state
Published
Issued date
05/2017
Peer-reviewed
Oui
Volume
9
Number
Suppl 5
Pages
S381-S385
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The optimal method for specimen preparation of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) is still controversial. This study aims to compare several techniques available for EBUS-TBNA specimen acquisition and processing, in order to identify the best performing technique.
We retrospectively reviewed the data of 199 consecutive patients [male, 73%; median age, 64 years (IQR: 52-74 years)] undergoing EBUS-TBNA at our institution from 2012 through 2014 for diagnosis of hilar-mediastinal lymph node enlargement suspect of neoplastic (n=139) or granulomatous (n=60) disease. All procedures were performed by two experienced bronchoscopists, under conscious sedation and local anaesthesia, using 21/22-Gauge (G) needle, without rapid on-site evaluation (ROSE). Five specimen-processing techniques were used: cytology slides in 42 cases (21%); cell-block in 25 (13%); core-tissue in 60 (30%); combination of cytology slides and core-tissue in 51 (26%); combination of cytology slides and cell-block in 21 (10%). To assess the diagnostic accuracy of each tissue-processing technique we compared the EBUS-TBNA results to those obtained with surgical lymphadenectomy, or 1-year follow-up in non-operated patients.
Diagnostic yield, accuracy and area under the curve (AUC) were as follows. Cytology slides: 81%, 80%, 0.90; cell-block: 48%, 33%, 0.67; core-tissue: 87%, 99%, 0.96; cytology slides + core-tissue: 80%, 100%, 1.00; cytology slides + cell-block: 86%, 100%, 1.00. Cytology slides and core-tissue method showed non-significantly different diagnostic yield (P=0.435) and AUC (P=0.152).
In our single-institution experience, cytology slides and core-tissue preparations demonstrated high and similar diagnostic performance. Cytology slides combination with core-tissue or cell-block showed the highest performance, however these combination methods were more resource-consuming.

Keywords
Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA), diagnostic accuracy, specimen preparation
Pubmed
Web of science
Create date
14/06/2017 10:12
Last modification date
20/08/2019 13:37
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