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

Détails

ID Serval
serval:BIB_10BAD525E602
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Comparison of multiple techniques for endobronchial ultrasound-transbronchial needle aspiration specimen preparation in a single institution experience.
Périodique
Journal of thoracic disease
Auteur(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
Statut éditorial
Publié
Date de publication
05/2017
Peer-reviewed
Oui
Volume
9
Numéro
Suppl 5
Pages
S381-S385
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
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.

Mots-clé
Endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA), diagnostic accuracy, specimen preparation
Pubmed
Web of science
Création de la notice
14/06/2017 9:12
Dernière modification de la notice
20/08/2019 12:37
Données d'usage