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  3. Determinants of false-negative results in non-small-cell lung cancer staging by endobronchial ultrasound-guided needle aspiration

Determinants of false-negative results in non-small-cell lung cancer staging by endobronchial ultrasound-guided needle aspiration

Fecha de publicación:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Sanz-Santos J
  • Serra M
  • Gallego M
  • Montón C
  • Cosio B
  • Sauleda J
  • Fernández-Villar A
  • García-Luján R
  • de Miguel E
  • Cordovilla R
  • Varela G
  • Andreo F
  • Monsó E

Grupos

Abstract

OBJECTIVES: False-negative results of endobronchial ultrasound-guided transbronchial needle aspiration in non-small-cell lung cancer staging have shown significant variability in previous studies. The aim of this study was to identify procedure-and tumour-related determinants of endobronchial ultrasound-guided transbronchial needle aspiration false-negative results. METHODS: We conducted a prospective study that included non-small-cell lung cancer patients staged as N0/N1 by endobronchial ultrasound-guided transbronchial needle aspiration and undergoing therapeutic surgery. The frequency of false-negative results in the mediastinum was calculated. Procedure-related, first, and tumour-related, second, determinants of false-negative results in stations reachable and non-reachable by endobronchial ultrasound were determined by multivariate logistic regression. RESULTS: False-negative endobronchial ultrasound-guided transbronchial needle aspiration results were identified in 23 of 165 enrolled patients (13.9%), mainly in stations reachable by endobronchial ultrasound (17 cases, 10.3%). False-negative results were related to the extensiveness of endobronchial ultrasound sampling: their prevalence was low (2.4%) when sampling of three mediastinal stations was satisfactory, but rose above 10% when this requirement was not fulfilled (P = 0.043). In the multivariate analysis, abnormal mediastinum on computer tomography/positron emission tomography [odds ratio (OR) 7.77, 95% confidence interval (CI) 2.19-27.51, P = 0.001] and extensiveness of satisfactory sampling of mediastinal stations (OR 0.37, 95% CI 0.16-0.89, P = 0.026) were statistically significant risk factors for false-negative results in stations reachable by endobronchial ultrasound. False-negative results in non-reachable nodes were associated with a left-sided location of the tumour (OR 10.11, 95% CI 1.17-87.52, P = 0.036). CONCLUSIONS: The presence of false-negative ultrasound-guided transbronchial needle aspiration results were observed in nearly 15% of non-small-cell lung cancer patients but in only 3% when satisfactory samples were obtained from three mediastinal stations. False-negative results in stations reachable by endobronchial ultrasound were associated with the extensiveness of sampling, and in stations out of reach of endobronchial ultrasound with left-sided tumours. These results suggest that satisfactory sampling of at least three mediastinal stations by EBUS-TBNA may be a quality criterion to be recommended for EBUS-TBNA staging.

Datos de la publicación

ISSN/ISSNe:
1010-7940, 1873-734X

EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY  OXFORD UNIV PRESS INC

Tipo:
Article
Páginas:
642-647
PubMed:
25005839
Factor de Impacto:
1,716 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 14

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Keywords

  • Non-small-cell lung cancer; Staging; Mediastinum; Endobronchial ultrasound-guided transbronchial needle aspiration; False negative

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