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Eur Respir J 2006, doi:10.1183/09031936.06.00125605
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ORIGINAL ARTICLE |
Combined TBNA and PET for mediastinal staging of non-small cell lung cancer
1 Pulmonary Medicine
2 Thoracic Surgery
3 Institute of Pathology
4 Nuclear Medicine, University Hospital Basel, Switzerland
* To whom correspondence should be addressed. E-mail: pchhajed{at}uhbs.ch.
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Abstract |
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There are no data available combining transbronchial needle aspiration of mediastinal lymph nodes and PET in the staging of non-small cell lung cancer.
We aimed to determine if these two methods can enhance the negative predictive value of the individual modality alone for a specific lymph node station and if this integrated approach can reduce the number of mediastinoscopies.
113 patients with enlarged mediastinal lymph node (
1 cm) who underwent both transbronchial needle aspiration and PET scanning were included. In 51 patients, histopathology confirmed by surgical lymph node dissection was compared with PET results and transbronchial needle aspiration.
Sensitivity, specificity, positive predictive value, negative predictive value and accuracy to detect malignant lymphadenopathy was 68% (13/19), 89% (119/134), 46% (13/28), 95% (119/125) and 86% (132/152) for PET; 54% (6/11), 100% (53/53), 100% (6/6), 91% (53/58) and 92% (59/64) for transbronchial needle aspiration; and 100% (11/11), 94% (50/53), 79% (11/14), 100% (50/50) and 95% (61/64) for combined transbronchial needle aspiration and PET respectively.
Combination of transbronchial needle aspiration and PET has the potential to allow adequate mediastinal staging of non small cell lung cancer with enlarged lymph nodes in most patients without the need for mediastinoscopy.
Keywords: Bronchoscopy, lung cancer, mediastinoscopy, transbronchial needle aspiration
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