Efficacy and adequacy of conventional transbronchial needle aspiration of IASLC stations 4R, 4L and 7 using endobronchial landmarks provided by the Wang nodal mapping system in the staging of lung cancer

Thoracic Cancer

Qinghua Liu⁵  Songyan Han²  Sixto Arias³  J Francis Turner¹  Hans Lee³  Robert Browning⁴ 

[1] Division of Pulmonary and Critical Care Medicine, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee, USA;Department of Respiratory Diseases, Shanxi Cancer Hospital, Taiyuan, China;Interventional Pulmonology, Division of Pulmonary Medicine and Critical Care, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA;Interventional Pulmonology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA;Department of Respiratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China

关键词: Bronchoscopy;    EBUS;    lung cancer;    transbronchial needle aspiration;   

DOI  :  10.1111/1759-7714.12288

来源: Wiley

【 摘 要 】

Abstract

Background

The role of transbronchial needle aspiration (TBNA) in the diagnosis and staging of lung cancer has been well established. Recently, the efficacy of conventional TBNA in the staging of lung cancer has been enhanced by the use of endobronchial ultrasound (EBUS)-TBNA. Our study sought to evaluate the adequacy of TBNA of International Association for the Study of Lung Cancer (IASLC) stations 4R, 4L and 7 using endobronchial landmarks provided by the Wang nodal mapping system in the staging of lung cancer.

Methods

We retrospectively analyzed all bronchoscopic cases with conventional TBNA punctures positive for malignancy at our institution from 1 January to 31 October 2014. The endobronchial puncture site was guided by the Wang nodal mapping system. The Wang stations were correlated with the IASLC lymph node map. No endobronchial ultrasound or rapid on-site evaluation was used. Pathological analysis included cytological and histological examination.

Results

Diagnosis by histological analysis was obtained in 115 (55.3%) out of 208 puncture sites. The metastatic lymph nodes were distributed at IASLC stations 4R (W1, 3, 5) 46.6 %, 7 (W2, 8, 10) 19.7%, 4L (W4, 6) 11.5%, 11R (W7, W9) 11.1% 11L (W11) 9.6%, 2R (high station W3) 0.5%, and the proximal portion of station 8 (station W10 beyond the middle lobe orifice) 1%. No complications were observed.

Conclusion

IASLC station 4R (W1, 3, 5), 7 (W2, 8, 10) and 4L (W4, 6) are adequate for the staging of lung cancer.

【 授权许可】

CC BY-NC   
© 2015 The Authors. Thoracic Cancer published by China Lung Oncology Group and Wiley Publishing Asia Pty Ltd.

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