Akif TURNA, Sedat ALTIN, Sinem Nedime SÖKÜCÜ, Levent KARASULU, Cengiz Ekrem SEYHAN, Erdoğan ÇETİNKAYA

Value of endobronchial ultrasound in staging non-small cell lung cancer

Endobronşiyal ultrason rehberliğinde ince iğne aspirasyonu (EBUS-TBİA), mediastinal lenfadenopatilerin değerlendirilmesinde doğru sonuç veren, güvenli ve minimal invazive bir tekniktir. Çalışmamızın amacı; tek kanallı bronkoskop kullanarak EBUS probunun katkısını ortaya koymaktır. Çalışmaya kanıtlanmış akciğer kanseri tanısı olan ve toraks bilgisayarlı tomografisinde genişlemiş (kısa aksı > 1 cm) mediastinal lenf nodu olduğu için EBUS-TBİA yapılan 22 hasta retrospektif olarak dahil edildi. Hastaların ortalama yaşı 56.8 ± 9.0 (45-76) olup, hepsi erkekti. Örneklenen 32 lenf nodunun ortalama büyüklüğü 19.9 ± 6.5 mm (10-30) idi. Ortalama örneklem sayısı 3.2 ± 0.9 (1-5) idi. Yeterli materyal lenf nodlarının 31 (%97)’inde elde edildi. On beş (%68.1) olguda lenf nodu metastazı tespit edildi. Negatif sitolojik sonuca ulaşılan 7 olguda mediastinoskopi uygulandı. Bir olgudaki minimal hemoraji dışında komplikasyon gözlenmedi. EBUS-TBİA’nın duyarlılığı %88.2, özgüllüğü %100, doğruluğu %90.9 olarak bulundu. Sonuç olarak; mediastinal lenf nodlarının EBUS rehberliğinde TBİA’sı küçük hücreli dışı akciğer kanserinde yüksek yeterlilik ve tanı oranı sağlayan güvenli bir araçtır.

Küçük hücreli dışı akciğer kanserinin evrelendirilmesinde endobronşiyal ultrasonun yeri

Endobronchial ultrasound guided fine-needle aspiration (EBUS-TBNA) is an accurate, safe and minimally invasive technique for the analysis of mediastinal lymph nodes. The aim of our study was to assess the value of EBUS probe using single-channel bronchoscope. Twenty-two patients who undervent EBUS-TBNA with proven non-small cell lung cancer and enlarged (> 1 cm) mediastinal lymph node at chest computed tomography were retrospectively enrolled in the study. The mean age of the patients was 56.8 ± 9.0 (45-76), and all of them were men. Mean size of sampled 32 lymph nodes was 19.9 ± 6.5 mm (10-30). The average number of needle passes was 3.2 ± 0.9 (1-5). Adequate material was found in 31 (97%) of the lymph nodes. In 15 (68.1%) of the patients lymph node metastasis was detected. Of 7 patients with negative cytology, a mediastinoscopy was done. There were no complications other than minimal hemorrhage. The sensitivity of EBUS-TBNA was calculated as 88.2%, whereas the specificity was 100% and accuracy was found to be 90.9%. EBUS guided TBNA of mediastinal lymph nodes is a safe approach which can be a tool for obtaining adequate material and high diagnostic yield in staging of non-small cell lung cancer.

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