Işın GÜNEŞ, Ömer ÖNAL, Nuri TUTAR, İnci GÜLMEZ, Şebnem GÜRSOY, Alper YURCİ, Özlem CANÖZ

Küçük hücreli dışı akciğer kanserinde endobronşiyal ve endoskopik ultrason rehberliğinde ince iğne aspirasyonunun mediastinal nodal evrelemedeki rolü

Giriş: Küçük hücreli dışı akciğer kanseri (KHDAK) hastalarında değişik tedavi modalitelerini değerlendirmek için anahtar noktalardan birisi mediastinal ve hiler nodal evrelemedir. Bu çalışmanın amacı endobronşiyal ultrason rehberliğinde transbronşiyal iğne aspirasyonu (EBUS-TBİA), endoskopik ultrason rehberliğinde ince iğne aspirasyonu (EUS-İİA) ve kombine EBUS-TBİA ile EUS-İİA’nın potansiyel olarak ameliyat edilebilecek hastalarda nodal evrelemedeki tanı başarısını saptamaktır. Materyal ve Metod: Mart 2014 ve Kasım 2015 tarihleri arasında ardı ardına 20 hasta çalışmaya dahil edildi. Tüm hastalar endosonografik işlemler öncesi potansiyel olarak ameliyat olabilecek KHDAK tanısı almıştı. Bulgular: Yirmi hastada EBUS-TBİA ile 30 lenf nodu, EUS-İİA ile 17 lenf nodu örneklendi. F-18 florodeoksiglukoz pozitron emisyon tomografi-bilgisayarlı tomografi (PET-BT), EBUS-TBİA, EUS-İİA ve kombine EBUS-TBİA ile EUS-İİA’nın sensitivite, spesifite, pozitif tahmini değer, negatif tahmini değer ve tanı başarısı sırasıyla %100, %33.3, %64.7, %100 ve %70.0; %81.8, %100, %100, %81.8 ve %90; %81.8, %100, %100, %75 ve %88.2; %90.9, %100, %100, %90.0 ve %95.0’dı. Sonuç: Kombine EBUS-TBİA ile EUS-İİA tekniği potansiyel olarak ameliyat olabilecek KHDAK hastalarının nodal evrelemesinde başarılı bir yöntemdir.

The role of endobronchial and endoscopic ultrasound guided fine needle aspiration for mediastinal nodal staging of non-small-cell lung cancer

Introduction: Mediastinal and hilar nodal staging is one of the key points for differentiating treatment modalities in patients with nonsmall-cell lung cancer (NSCLC). The aim of the present study was to determinate the diagnostic yields of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) andcombined EBUS-TBNA and EUS-FNA modalities for nodal staging in potentially operable NSCLC patients.Materials and Methods: Twenty consecutive patients were prospectively enrolled in the study between March 2014 andNovember 2015. All patients had a potentially operable NSCLCdiagnosis before endosonographic procedures.Results: Thirty lymph nodes were sampled by EBUS-TBNA and 17lymph nodes were sampled by EUS-FNA in all 20 patients. Thesensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of F-18 fluorodeoxyglucose positron emission tomography with computed tomography (PET-CT),EBUS-TBNA, EUS-FNA and combined EBUS-TBNA and EUS-FNA were 100%, 33.3%, 64.7%, 100% and 70.0%; 81.8%, 100%,100%, 81.8% and 90%; 81.8%, 100%, 100%, 75% and 88.2%; 90.9%, 100%, 100%, 90.0% and 95.0%, respectively.Conclusion: The combined EBUS-TBNA and EUS-FNA technique is a successful procedure for nodal staging in potentially operableNSCLC patients.

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