Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration
Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in samp...
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The Korean Academy of Tuberculosis and Respiratory Diseases
2025-07-01
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| Series: | Tuberculosis and Respiratory Diseases |
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| Online Access: | http://e-trd.org/upload/pdf/trd-2024-0134.pdf |
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| author | Pipu Tavornshevin Poonchavist Chantranuwatana Vorawut Thanthitaweewat Virissorn Wongsrichanalai Thitiwat Sriprasart Nophol Leelayuwatanakul |
| author_facet | Pipu Tavornshevin Poonchavist Chantranuwatana Vorawut Thanthitaweewat Virissorn Wongsrichanalai Thitiwat Sriprasart Nophol Leelayuwatanakul |
| author_sort | Pipu Tavornshevin |
| collection | DOAJ |
| description | Background Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in sampling LNs. Methods We assessed tissue adequacy in patients with mediastinal and hilar lymphadenopathy, comparing the combination of EBUS-MFB and EBUS-TBNA with EBUS-TBNA alone. EBUS-MFB was performed with the guide sheath (GS) dilatation technique. Tissue adequacy was a tumor cell count (TCC) of >100 and neoplastic cell neoplastic cell estimate of >25%. Further, we reported the diagnostic yield, tumor cell characteristics, and safety outcomes. Results Among 69 patients (74 nodes), malignant diseases were diagnosed in 41 nodes using both techniques. Tissue adequacy with EBUS-TBNA (93.8% in 30/32 nodes) was comparable with the combined group (96.9% in 31/32 nodes, p=0.317). EBUS-TBNA yielded higher TCC (84.4% with >1,000 cells) than EBUS-MFB (53.1%, p=0.004). The combined approach significantly improved the diagnostic yield in non-malignant diseases compared with EBUS-TBNA alone (97% vs. 78.8%, p=0.014). Of the 32 nodes, 20 demonstrated discordant results between EBUS-TBNA and EBUS-MFB, with EBUS-MFB correctly diagnosing six nodes that EBUS-TBNA misdiagnosed. The complication rate was low (2.9%) with only minor bleeding reported. Conclusion EBUS-TBNA alone and the combination of EBUS-MFB and EBUS-TBNA demonstrated comparable tissue adequacy, with EBUS-TBNA exhibiting better specimen characteristics, potentially sufficient for various molecular analyses. The addition of EBUS-MFB, performed using the GS-dilatation technique, to EBUS-TBNA improved the diagnostic yield and proved to be a safe and efficient approach, particularly in non-malignant diseases. |
| format | Article |
| id | doaj-art-bf33347d58cf4e50bf71fbb54339d794 |
| institution | Kabale University |
| issn | 1738-3536 2005-6184 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | The Korean Academy of Tuberculosis and Respiratory Diseases |
| record_format | Article |
| series | Tuberculosis and Respiratory Diseases |
| spelling | doaj-art-bf33347d58cf4e50bf71fbb54339d7942025-08-20T03:33:14ZengThe Korean Academy of Tuberculosis and Respiratory DiseasesTuberculosis and Respiratory Diseases1738-35362005-61842025-07-0188354555610.4046/trd.2024.01344941Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle AspirationPipu Tavornshevin0Poonchavist Chantranuwatana1Vorawut Thanthitaweewat2Virissorn Wongsrichanalai3Thitiwat Sriprasart4Nophol Leelayuwatanakul5 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, Thailand Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chulalongkorn University, Bangkok, ThailandBackground Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a predominantly used method for lymph node (LN) metastasis assessment. This study aims to identify tissue adequacy improvement with the addition of EBUS-guided miniforcep biopsy (EBUS-MFB) to EBUS-TBNA in sampling LNs. Methods We assessed tissue adequacy in patients with mediastinal and hilar lymphadenopathy, comparing the combination of EBUS-MFB and EBUS-TBNA with EBUS-TBNA alone. EBUS-MFB was performed with the guide sheath (GS) dilatation technique. Tissue adequacy was a tumor cell count (TCC) of >100 and neoplastic cell neoplastic cell estimate of >25%. Further, we reported the diagnostic yield, tumor cell characteristics, and safety outcomes. Results Among 69 patients (74 nodes), malignant diseases were diagnosed in 41 nodes using both techniques. Tissue adequacy with EBUS-TBNA (93.8% in 30/32 nodes) was comparable with the combined group (96.9% in 31/32 nodes, p=0.317). EBUS-TBNA yielded higher TCC (84.4% with >1,000 cells) than EBUS-MFB (53.1%, p=0.004). The combined approach significantly improved the diagnostic yield in non-malignant diseases compared with EBUS-TBNA alone (97% vs. 78.8%, p=0.014). Of the 32 nodes, 20 demonstrated discordant results between EBUS-TBNA and EBUS-MFB, with EBUS-MFB correctly diagnosing six nodes that EBUS-TBNA misdiagnosed. The complication rate was low (2.9%) with only minor bleeding reported. Conclusion EBUS-TBNA alone and the combination of EBUS-MFB and EBUS-TBNA demonstrated comparable tissue adequacy, with EBUS-TBNA exhibiting better specimen characteristics, potentially sufficient for various molecular analyses. The addition of EBUS-MFB, performed using the GS-dilatation technique, to EBUS-TBNA improved the diagnostic yield and proved to be a safe and efficient approach, particularly in non-malignant diseases.http://e-trd.org/upload/pdf/trd-2024-0134.pdfendobronchial ultrasoundtransbronchial needle aspirationminiforcep biopsymediastinal and hilar lymphadenopathytissue adequacy |
| spellingShingle | Pipu Tavornshevin Poonchavist Chantranuwatana Vorawut Thanthitaweewat Virissorn Wongsrichanalai Thitiwat Sriprasart Nophol Leelayuwatanakul Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration Tuberculosis and Respiratory Diseases endobronchial ultrasound transbronchial needle aspiration miniforcep biopsy mediastinal and hilar lymphadenopathy tissue adequacy |
| title | Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration |
| title_full | Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration |
| title_fullStr | Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration |
| title_full_unstemmed | Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration |
| title_short | Tissue Adequacy and Diagnostic Yield Assessment in Malignant Lymph Nodes Using Endobronchial Ultrasound (EBUS)-Guided Miniforcep Biopsy vs. EBUS-Guided Transbronchial Needle Aspiration |
| title_sort | tissue adequacy and diagnostic yield assessment in malignant lymph nodes using endobronchial ultrasound ebus guided miniforcep biopsy vs ebus guided transbronchial needle aspiration |
| topic | endobronchial ultrasound transbronchial needle aspiration miniforcep biopsy mediastinal and hilar lymphadenopathy tissue adequacy |
| url | http://e-trd.org/upload/pdf/trd-2024-0134.pdf |
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