Endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing thoracic lesions: a retrospective cohort study

Huibin Liao; Miaojuan Zhu; Ru Li; DeXin Wang; Dan Xiao; Yifei Chen; Zhenshun Cheng

doi:10.3389/fmed.2024.1383600

Endobronchial ultrasound-guided transbronchial needle aspiration for diagnosing thoracic lesions: a retrospective cohort study

Front Med (Lausanne). 2024 May 10:11:1383600. doi: 10.3389/fmed.2024.1383600. eCollection 2024.

Authors

Huibin Liao^#¹, Miaojuan Zhu^#¹, Ru Li^#², DeXin Wang^#³, Dan Xiao⁴, Yifei Chen¹, Zhenshun Cheng^{1

5}

Affiliations

¹ Department of Respiratory and Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China.
² Department of Respiratory and Critical Care Medicine, Macheng Second People's Hospital, Huanggang, China.
³ Department of Respiratory and Critical Care Medicine, Qichun County People's Hospital, Huanggang, China.
⁴ Department of Respiratory and Critical Care Medicine, Xishui Hospital Affiliated to Hubei University of Science and Technology, Huanggang, China.
⁵ Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China.

^# Contributed equally.

Abstract

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique for biopsy of lung, peri-pulmonary tissue and lymph nodes under real-time ultrasound-guided biopsy. It is used in the diagnosis and/or staging of benign and malignant pulmonary and non-pulmonary diseases. Our study is based on a large sample size, in a diversified population which provides a representative real-world cohort for analysis.

Methods: Patients who underwent EBUS-TBNA procedure between September 2019 and August 2022 were included in this retrospective study. For cases diagnosed as benign and unclassified lesions by EBUS-TBNA, the final diagnosis was determined by further invasive surgery or a combination of therapy and clinical follow-up for at least 6 months.

Results: A total of 618 patients were included in the study, including 182 females (29.4%) and 436 males (70.6%). The mean age of all patients was 61.9 ± 10.5 years. These patients were successfully punctured by EBUS-TBNA to obtain pathological results. The pathological diagnosis results of EBUS-TBNA were compared with the final clinical diagnosis results as follows: 133 cases (21.5%) of benign lesions and 485 cases (78.5%) of malignant lesions were finally diagnosed. Among them, the pathological diagnosis was obtained by EBUS-TBNA in 546 patients (88.3%) (464 malignant lesions and 82 benign conditions), while EBUS-TBNA was unable to define diagnosis in 72 patients (11.6%). 20/72 non-diagnostic EBUS-TBNA were true negative. The overall diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EBUS-TBNA were 91.3%, 100%, 100%, 27.8%, and 91.6% [95% confidence interval (CI): 89.1-93.6%], respectively. In this study, only one case had active bleeding without serious complications during the EBUS-TBNA procedure.

Conclusion: Given its low invasiveness, high diagnostic accuracy, and safety, EBUS-TBNA is worth promoting in thoracic lesions.

Keywords: diagnostic performance; endobronchial ultrasound-guided transbronchial needle aspiration; indication; real-world; thoracic lesions.

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This research was funded by the Climbing Project for Medical Talent of Zhongnan Hospital, Wuhan University (Grant no. PDJH202205) and Translational Medicine and Interdisciplinary Research Joint Found of Zhongnan Hospital of Wuhan University (Grant no. ZNJC202218).