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The characteristics of patients undergoing endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA): single-center experience

Year 2024, , 155 - 159, 28.06.2024
https://doi.org/10.47582/jompac.1473255

Abstract

Aims: We aimed to present the features of our Endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA) cases, the lymph nodes that were biopsied, their pathological diagnoses, and the complications that developed due to the procedure.
Methods: All cases who underwent EBUS-TBNA between January 2016 and December 2023 in the chest diseases clinic of a training and research hospital were retrospectively screened. The patients who underwent the procedure (n=274) were included in the study. Cases in which fine needle aspiration biopsy was performed with EBUS-TBNA and the material obtained was not diagnostic (n=3) or in which the pathology result could not be obtained in the files (n=9) were excluded from the study. The design of our study was cross-sectional and planned as a descriptive study.
Results: Of the 262 patients included in the analysis, 66.4% (n=174) were male and the average age of the population was 60.8±11.4 years. When EBUS-TBNA indications were evaluated, the procedure was performed for diagnostic purposes in 96.9% (n=254) and for re-evaluation after chemotherapy in 3.1%. EBUS-TBNA procedure was performed in 16.8% (n=44) patients due to mediastinal mass and in 83.2% (n=218) patients due to mediastinal lymphadenopathy. The most common stations where biopsy is performed with the EBUS-TBNA process are the subcarinal (7) and lower right paratracheal (4R) lymph node stations. When the biopsy results were evaluated, malignancy was reported in 54.6% (n=143) of the patients. The complications related to the EBUS-TBNA procedure were generally mild and trancient .
Conclusion: EBUS-TBNA is a minimally invasive method used in the diagnosis and staging of lung cancer, the evaluation of non-endobronchial lesions, the diagnosis of benign diseases of the mediastinum, and the diagnosis of mediastinal metastases of extrathoracic malignancies. In experienced centers like our clinic, the diagnostic value of the procedure is high and the complication rates are very low.

References

  • De Leyn P, Dooms C, Kuzdzal J, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(5):787-798.
  • Murthi M, Donna E, Arias S, et al. Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in real life. Front Med (Lausanne). 2020;7:118.
  • Wahidi MM, Herth F, Yasufuku K, et al. Technical aspects of endobronchial ultrasound-guided transbronchial needle aspiration: CHEST guideline and expert panel report. Chest. 2016;149(3):816-835.
  • Muriana P, Rossetti F. The role of EBUS-TBNA in lung cancer restaging and mutation analysis. Mediastinum. 2020;30(4):23.
  • Yamamoto S, Nakayama M. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): revolutionizing the landscape of lung disease diagnostics. J Med Ultrason (2001). 2024;51(2):245-251. doi: 10.1007/s10396-023-01391-y
  • Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol. 2023;20(9):624-639.
  • Torre M, Reda M, Musso V, Danuzzo F, Mohamed S, Conforti S. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum. 2021:25(5):15.
  • Yılmaz MU, Erol S, Ermete S, et al. Endobronşial ultrason-transbronşial iğne aspirasyonu; öğrenme dönemi sonuçları. İzmir Göğ Hast Derg. 2015;29(1):15-20.
  • Öztürk A, Çiçek T, Yılmaz A. What is the yield of EBUS-TBNA for re-evaluation of previously treated non-small-cell lung cancer? Turk J Med Sci. 2023;53(2):586-593.
  • Batum Ö, Katgı N, Özdemir Ö, Yılmaz U. Diagnostic efficacy of EBUS-TBNA in benign diseases in a population with a high prevalence of tuberculosis. Diagn Cytopathol. 2021;49(3):374-380.
  • Ortakoylu MG, Iliaz S, Bahadir A, et al. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases. J Bras Pneumol. 2015; 41(5):410-414.
  • Demirdöğen E, Ursavaş A, Aydın Güçlü Ö, Acet Öztürk NA, Özkaya G, Karadağ M. Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tuberk Toraks. 2020;68(3):285-292.
  • Tertemiz KC, Alpaydin AO, Karacam V. The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy. Surg Endosc. 2017;31(7):2829-2836.
  • Fournier C, Hermant C, Gounant V, et al. Diagnostic of mediastinal lymphadenopathy in extrathoracic cancer: a place for EBUS-TBNA in real life practice? Respir Med Res. 2019;75:1-4.
  • Navani N, Nankivell M, Woolhouse I, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy: a multicenter study. J Thorac Oncol. 2011;6(9):1505-1509.
  • Sanz-Santos J, Cirauqui B, Sanchez E, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies. Clin Exp Metastasis. 2013;30(4):521-528.
  • Şentürk A, Çelik D, Aksoy Altınboğa A. Rapid on-site evaluation (ROSE) during endobronchial ultrasound bronchoscopy (EBUS) in the diagnosis of granulomatous diseases. Int J Clin Pract. 2021;75(12):e15002. doi: 10.1111/ijcp.15002
  • Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer. 2009;45(8):1389-1396.
  • Çağlayan B, Yılmaz A, Bilaçeroğlu S, Cömert SŞ, Demirci NY, Salepçi B. Complications of convex-probe endobronchial ultrasound-guided transbronchial needle aspiration: a multi-center retrospective study. Respir Care. 2016;61(2):243-248.

Endobronşiyal ultrasonografi eşliğinde transbronşiyal iğne aspirasyonu (EBUS-TBNA) uygulanan hastaların genel özellikleri: Tek merkez deneyimi

Year 2024, , 155 - 159, 28.06.2024
https://doi.org/10.47582/jompac.1473255

Abstract

Amaç: EBUS-TBNA olgularımızın tüm özelliklerini ve biyopsi uygulanan lenf nodlarını, patolojik tanılarını ve işleme bağlı gelişen komplikasyonları sunmayı amaçladık
Materyal ve Metod: Bir eğitim ve araştırma hastanesi göğüs hastalıkları kliniğinde Ocak 2016 – Aralık 2023 tarihleri arasında EBUS-TBNA yapılan tüm olgular retrospektif olarak tarandı. İşlem yapılmış 274 olgu çalışmaya dahil edildi. EBUS-TBNA ile ince iğne aspirasyon biyopsi yapılıp alınan materyal tanısal olmayan (n=3) veya kayıtlarda patoloji sonucuna ulaşılamayan (n=9) olgular çalışma dışı bırakıldı. Çalışmamızın dizaynı kesitsel olup tanımlayıcı bir çalışma olarak planlanmıştır.
Results: Analize dahil edilen 262 hastanın %66.4 (n=174) erkekti ve tüm populasyonın yaş ortalaması 60.8±11.4 idi. EBUS-TBNA endikasyonları değerlendirildiğinde %96.9 unda (n=254) işlem tanısal amaçlı %3.1 inde ise işlem kemoterapi sonrası yeniden değerlendirme amacıyla gerçekleştirildi. EBUS-TBNA işlemi %16.8 (n=44) hastada mediastinal kitle nedeniyle, %83.2 (n=218) hastada ise mediastinal lenfadenopati nedeniyle uygulandı. EBUS-TBNA işlemi ile biyopsinin uygulandığı en sık istasyon subkarinal (7) ve sağ alt paratrakeal (4R) lenf nodu istasyonlarıdır. Biyopsi sonuçları değerlendirildiğinde hastaların %54,6 ünde (n=143) malignite raporlandı EBUS-TBNA işlemine bağlı komplikasyonlar genel olarak hafif ve geçici idi.
Conclusion: EBUS-TBNA akciğer kanseri tanı ve evrelemesinde, endobronşiyal olmayan lezyonların tanısında, mediastenin benign hastalıklarının tanısında ve extratorasik malignitelerin mediastinal metastazlarının tanısında kullanılan minimal invaziv yöntemdir. Bizim kliniğimiz gibi deneyimli merkezlerde işlem sonuçlarının tanısal değeri yüksek ve komplikasyon oranları çok düşük olmaktadır.

References

  • De Leyn P, Dooms C, Kuzdzal J, et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(5):787-798.
  • Murthi M, Donna E, Arias S, et al. Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in real life. Front Med (Lausanne). 2020;7:118.
  • Wahidi MM, Herth F, Yasufuku K, et al. Technical aspects of endobronchial ultrasound-guided transbronchial needle aspiration: CHEST guideline and expert panel report. Chest. 2016;149(3):816-835.
  • Muriana P, Rossetti F. The role of EBUS-TBNA in lung cancer restaging and mutation analysis. Mediastinum. 2020;30(4):23.
  • Yamamoto S, Nakayama M. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA): revolutionizing the landscape of lung disease diagnostics. J Med Ultrason (2001). 2024;51(2):245-251. doi: 10.1007/s10396-023-01391-y
  • Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol. 2023;20(9):624-639.
  • Torre M, Reda M, Musso V, Danuzzo F, Mohamed S, Conforti S. Diagnostic accuracy of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging of lung cancer. Mediastinum. 2021:25(5):15.
  • Yılmaz MU, Erol S, Ermete S, et al. Endobronşial ultrason-transbronşial iğne aspirasyonu; öğrenme dönemi sonuçları. İzmir Göğ Hast Derg. 2015;29(1):15-20.
  • Öztürk A, Çiçek T, Yılmaz A. What is the yield of EBUS-TBNA for re-evaluation of previously treated non-small-cell lung cancer? Turk J Med Sci. 2023;53(2):586-593.
  • Batum Ö, Katgı N, Özdemir Ö, Yılmaz U. Diagnostic efficacy of EBUS-TBNA in benign diseases in a population with a high prevalence of tuberculosis. Diagn Cytopathol. 2021;49(3):374-380.
  • Ortakoylu MG, Iliaz S, Bahadir A, et al. Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in various lung diseases. J Bras Pneumol. 2015; 41(5):410-414.
  • Demirdöğen E, Ursavaş A, Aydın Güçlü Ö, Acet Öztürk NA, Özkaya G, Karadağ M. Diagnostic performance of EBUS-TBNA and its interrelation with PET-CT in patients with extra-thoracic malignancies. Tuberk Toraks. 2020;68(3):285-292.
  • Tertemiz KC, Alpaydin AO, Karacam V. The role of endobronchial ultrasonography for mediastinal lymphadenopathy in cases with extrathoracic malignancy. Surg Endosc. 2017;31(7):2829-2836.
  • Fournier C, Hermant C, Gounant V, et al. Diagnostic of mediastinal lymphadenopathy in extrathoracic cancer: a place for EBUS-TBNA in real life practice? Respir Med Res. 2019;75:1-4.
  • Navani N, Nankivell M, Woolhouse I, et al. Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrathoracic lymphadenopathy in patients with extrathoracic malignancy: a multicenter study. J Thorac Oncol. 2011;6(9):1505-1509.
  • Sanz-Santos J, Cirauqui B, Sanchez E, et al. Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies. Clin Exp Metastasis. 2013;30(4):521-528.
  • Şentürk A, Çelik D, Aksoy Altınboğa A. Rapid on-site evaluation (ROSE) during endobronchial ultrasound bronchoscopy (EBUS) in the diagnosis of granulomatous diseases. Int J Clin Pract. 2021;75(12):e15002. doi: 10.1111/ijcp.15002
  • Gu P, Zhao YZ, Jiang LY, Zhang W, Xin Y, Han BH. Endobronchial ultrasound-guided transbronchial needle aspiration for staging of lung cancer: a systematic review and meta-analysis. Eur J Cancer. 2009;45(8):1389-1396.
  • Çağlayan B, Yılmaz A, Bilaçeroğlu S, Cömert SŞ, Demirci NY, Salepçi B. Complications of convex-probe endobronchial ultrasound-guided transbronchial needle aspiration: a multi-center retrospective study. Respir Care. 2016;61(2):243-248.
There are 19 citations in total.

Details

Primary Language English
Subjects Chest Diseases
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Savaş Gegin 0000-0001-7362-8710

Burcu Özdemir 0000-0003-4678-7729

Esra Arslan Aksu 0000-0003-0448-1801

İrem Yazıcıoğlu This is me 0000-0002-8190-6722

Levent Özdemir 0000-0002-3478-5454

Publication Date June 28, 2024
Submission Date April 25, 2024
Acceptance Date May 19, 2024
Published in Issue Year 2024

Cite

AMA Gegin S, Özdemir B, Arslan Aksu E, Yazıcıoğlu İ, Özdemir L. The characteristics of patients undergoing endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA): single-center experience. J Med Palliat Care / JOMPAC / Jompac. June 2024;5(3):155-159. doi:10.47582/jompac.1473255

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