Evaluation of Mediastinal Lymphadenopathy with Endoscopic US-guided Fine-Needle Aspiration Biopsy

作者：Maurits J. Wiersema, Enrique Vázquez-Sequeiros, Lisa M. Wiersema · 发表于：Radiology · 年份：2001 · DOI：10.1148/radiology.219.1.r01ap44252 · 被引用次数：177 · 研究领域：Lung Cancer Diagnosis and Treatment、Lymphadenopathy Diagnosis and Analysis、Tracheal and airway disorders

PURPOSE: To evaluate the safety and accuracy of endoscopic ultrasonography (US)-guided fine-needle aspiration biopsy (FNAB) of lymph nodes in the paratracheal, aortopulmonic, subcarinal, and posterior mediastinal regions. MATERIALS AND METHODS: Eighty-six consecutive patients with mediastinal lymphadenopathy who did not have a primary gastrointestinal neoplasm were examined. In 29 patients, endoscopic US-guided FNAB of mediastinal lymphadenopathy was performed as a component of staging non-small cell lung cancer (NSCLC); in the remaining 57 patients, it was performed to obtain a primary diagnosis. Final diagnosis was based on clinical follow-up, cytologic, and/or surgical results. RESULTS: In 82 patients in whom a final diagnosis was available, the sensitivity, specificity, accuracy, negative predictive value, and positive predictive value of endoscopic US-guided FNAB in distinguishing benign from malignant mediastinal lymph nodes were 96%, 100%, 98%, 94%, and 100%, respectively. In those patients who underwent staging of NSCLC, endoscopic US-guided FNAB had superior mediastinal lymph node staging accuracy compared with endoscopic US alone (79%) and CT alone (79%) (P =.01). The results of endoscopic US-guided FNAB prompted a change to nonsurgical management in 66 (80%) of 82 patients who underwent the procedure. One minor complication, postprocedural fever that resolved with oral antibiotics, occurred (1%; 95% CI: 0%, 6%). CONCLUSION: Endoscopic US-guided FNAB is accurate and...