Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging

Background. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) has been accepted as a procedure for the diagnos...

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Main Authors: S. Arias, Q. H. Liu, B. Frimpong, H. Lee, D. Feller-Kopman, L. Yarmus, K. P. Wang
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2016/1652178
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author S. Arias
Q. H. Liu
B. Frimpong
H. Lee
D. Feller-Kopman
L. Yarmus
K. P. Wang
author_facet S. Arias
Q. H. Liu
B. Frimpong
H. Lee
D. Feller-Kopman
L. Yarmus
K. P. Wang
author_sort S. Arias
collection DOAJ
description Background. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) has been accepted as a procedure for the diagnosis and staging of lung cancer. The aim of this study is to evaluate the efficacy and adequacy of TBNA and EBUS-TBNA for sampling of mediastinal adenopathy using the Wang’s eleven lymph node map stations. Methods. We retrospectively reviewed 99 consecutive cases diagnosed with malignancy by EBUS-TBNA and a series 74 patients evaluated for mediastinal adenopathy or a pulmonary lesion using conventional transbronchial needle aspiration. The IASLC lymph node map was correlated with Wang’s map. Results. A total of 182 lymph node stations were sampled using EBUS-TBNA. 96 were positive for nodal metastasis. A total of four cases of samples taken from station 2R showed malignant cells. From the 74 cases series using cTBNA 167 nodes were sampled in 222 passes. Lymphoid or malignant tissue was obtained in 67 (91.8%) cases; 55.1% of the nodes were 1 cm or less. Conclusions. The use of the eleven stations described in Wang’s map to guide TBNA of the mediastinal nodes allows sampling of radiologically considered nonpathological nodes. These data suggest that Wang’s map covers the most frequent IASLC nodal stations compromised with metastasis.
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spelling doaj-art-541509f2b444452eacd34bdbb19618842025-08-20T03:36:23ZengWileyCanadian Respiratory Journal1198-22411916-72452016-01-01201610.1155/2016/16521781652178Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer StagingS. Arias0Q. H. Liu1B. Frimpong2H. Lee3D. Feller-Kopman4L. Yarmus5K. P. Wang6Interventional Pulmonology, Division of Pulmonary Medicine and Critical Care, University of Miami Miller School of Medicine, Miami, FL, USADepartment of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, 9677 Jingshi East Road, Jinan 250041, ChinaInterventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USAInterventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USAInterventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USAInterventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USAInterventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, 1800 Orleans Street, Suite 7125L, Baltimore, MD 21287, USABackground. Lung cancer is the leading cause of malignancy related mortality in the United States. Accurate staging of NSCLC influences therapeutic decisions. Transbronchial needle aspiration (TBNA) and endobronchial ultrasound-guided TBNA (EBUS-TBNA) has been accepted as a procedure for the diagnosis and staging of lung cancer. The aim of this study is to evaluate the efficacy and adequacy of TBNA and EBUS-TBNA for sampling of mediastinal adenopathy using the Wang’s eleven lymph node map stations. Methods. We retrospectively reviewed 99 consecutive cases diagnosed with malignancy by EBUS-TBNA and a series 74 patients evaluated for mediastinal adenopathy or a pulmonary lesion using conventional transbronchial needle aspiration. The IASLC lymph node map was correlated with Wang’s map. Results. A total of 182 lymph node stations were sampled using EBUS-TBNA. 96 were positive for nodal metastasis. A total of four cases of samples taken from station 2R showed malignant cells. From the 74 cases series using cTBNA 167 nodes were sampled in 222 passes. Lymphoid or malignant tissue was obtained in 67 (91.8%) cases; 55.1% of the nodes were 1 cm or less. Conclusions. The use of the eleven stations described in Wang’s map to guide TBNA of the mediastinal nodes allows sampling of radiologically considered nonpathological nodes. These data suggest that Wang’s map covers the most frequent IASLC nodal stations compromised with metastasis.http://dx.doi.org/10.1155/2016/1652178
spellingShingle S. Arias
Q. H. Liu
B. Frimpong
H. Lee
D. Feller-Kopman
L. Yarmus
K. P. Wang
Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
Canadian Respiratory Journal
title Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
title_full Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
title_fullStr Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
title_full_unstemmed Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
title_short Role of the Endobronchial Landmarks Guiding TBNA and EBUS-TBNA in Lung Cancer Staging
title_sort role of the endobronchial landmarks guiding tbna and ebus tbna in lung cancer staging
url http://dx.doi.org/10.1155/2016/1652178
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