Background: Combined endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) and endoscopic ultrasound-guided tissue acquisition (EUS-TA) are accurate procedures for the diagnosis and staging of mediastinal lymph nodes (MLNs) in lung cancer. However, the respective contribution of separate and combined procedures in diagnosis and staging has not been fully studied. The aim of this study was to assess their respective performances. Methods: Patients with suspected malignant MLNs in lung cancer or recurrence identified by PET-CT who underwent combined EBUS-TBNA and EUS-TA were retrospectively reviewed. Results: A total of 141 patients underwent both procedures. Correct diagnosis was obtained in 82% with EBUS-TBNA, 91% with EUS-TA, and 94% with the combined procedure. The overall sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of EBUS-TBNA, EUS-TA, and the combined procedure for diagnosing malignancy were [75%, 100%, 100%, 58%], [87%, 100%, 100%, 75%], and [93%, 100%, 100%, 80%], respectively, with a significantly better sensitivity of the combined procedure (p< 0.0001). Staging (82/141 patients) was correctly assessed in 74% with EBUS-TBNA, 68% with EUS-TA, and 85% with the combined procedure. The overall sensitivity, specificity, PPV, and NPV of EBUS-TBNA, EUS-TA, and the combined procedure for lung cancer staging were [62%, 100%, 100%, 55%], [54%, 100%, 100%, 50%], and [79%, 100%, 100%, 68%], respectively, significantly better in terms of sensitivity for the combined procedure (p< 0.001). Conclusion: The combined EBUS-EUS approach in lung cancer patients showed better accuracy and sensitivity in diagnosis and staging when compared with EBUS-TBNA and EUS-TA alone.
背景：支气管内超声引导下经支气管针吸活检（EBUS-TBNA）联合内镜超声引导下组织获取术（EUS-TA）是诊断和分期肺癌纵隔淋巴结（MLNs）的精确方法。然而，单独与联合操作在诊断和分期中的各自贡献尚未得到充分研究。本研究旨在评估它们各自的性能。方法：回顾性分析了经PET-CT检查疑似恶性纵隔淋巴结或复发的肺癌患者，这些患者接受了EBUS-TBNA和EUS-TA联合操作。结果：共有141名患者接受了两种操作。EBUS-TBNA的正确诊断率为82%，EUS-TA为91%，联合操作为94%。EBUS-TBNA、EUS-TA和联合操作在诊断恶性肿瘤方面的总体敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为[75%、100%、100%、58%]、[87%、100%、100%、75%]和[93%、100%、100%、80%]，联合操作的敏感性显著更优（p<0.0001）。在分期方面（141名患者中的82名），EBUS-TBNA的正确评估率为74%，EUS-TA为68%，联合操作为85%。EBUS-TBNA、EUS-TA和联合操作在肺癌分期方面的总体敏感性、特异性、PPV和NPV分别为[62%、100%、100%、55%]、[54%、100%、100%、50%]和[79%、100%、100%、68%]，联合操作在敏感性方面显著更优（p<0.001）。结论：与单独使用EBUS-TBNA或EUS-TA相比，EBUS-EUS联合方法在肺癌患者的诊断和分期中显示出更高的准确性和敏感性。
肿瘤(癌症)患者之家