Abstract
Introduction: EBUS-TBNA as first step of invasive staging in proved lung cancer in most of publications (Eur Respir J. 2009) The more difficult situation in country with high prevalence of tuberculosis. Aim: we decided to check the usefulness of EBUS-TBNA in cases of mediastinal lymphadenopathy in patients without clinical symptoms from Russia. Methods: a single-center, prospective, non-randomized trial. Inclusion criteria: age> / = 18 years with mediastinal lymphadenopathy with suspected sarcoidosis, median size of lymph node was 26+/-6 mm, informed consent to the study. Methods: EBUS-TBNA with conventional cytology examination of slides and cytoblocks of aspirate of lymph nodes were done. PCR for MBT, bacteriology of aspirates were done in all cases. 6-month follow-up.: 95 patients from April 2010 until December 2013 year were included in trial. Mean age was 40+/-13 years old. All the patients were randomized into 2 groups: group 1 -53 patients (VATS procedure were done in the same time with EBUS-TBNA), group 2 – 42 patients ( VATS procedure were done if EBUS-TBNA were no informative) Results: Final diagnosis were sarcoidosis-59, tuberculosis-10, lung cancer – 20, non-specific inflammation -6. Diagnosis was established in accordance with the guideline. Overall sensitivity of EBUS-TBNA was 62,1%. Sensitivity of EBUS-TBNA in G1 – 62%, in G2 – 60%. Conclusion: EBUS-TBNA can be used as first step procedure for differential diagnosis of mediastinal lymphadenopathy in country with high prevalence of tuberculosis in mostly cases.
- © 2014 ERS
