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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2019.031    [Accepted]
Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration for Re-biopsy in Previously Treated Lung Cancer
Joohae Kim1, Hyo Jae Kang1, Sung Ho Moon1, Jong Mog Lee1, Hyae Young Kim1, Geon-Kook Lee1,2, Jin Soo Lee1, Bin Hwangbo1
1Center for Lung Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
2Department of Pathology, Research Institute and Hospital, National Cancer Center, Goyang, Korea
Correspondence  Bin Hwangbo ,Tel: 82-031-920-1718 , Fax: 82-031-920-1275, Email: hbb@ncc.re.kr
Received: January 12, 2019;  Accepted: March 12, 2019.  Published online: March 15, 2019.
Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is widely used for the diagnosis and staging of lung cancer. However, evidence of its usefulness for re-biopsy in treated lung cancer, especially according to the previous treatment, is limited. We evaluated the role of EBUS-TBNA for re-biopsy and its diagnostic values in patients with different treatment histories.
Materials and Methods
We reviewed the medical records of patients who underwent EBUS-TBNA for re-biopsy of suspicious recurrent or progressive lesions between January 2006 and December 2016 at the National Cancer Center in South Korea. Patients were categorized into three groups based on the previous treatment modalities: surgery, radiation, and palliation.
Among the 367 patients (surgery, n=192; radiation, n=40; palliation, n=135) who underwent EBUS-TBNA for re-biopsy, the overall sensitivity, negative predictive value (NPV), and diagnostic accuracy of EBUS-TBNA in detecting malignancy were 95.6%, 82.7%, and 96.3%, respectively. The sensitivity was lower in the radiation group (83.3%) when compared with the surgery (95.7%, p=0.042) and palliation (97.7%, p=0.012) groups. The NPV was lower in the palliation group (50.0%) than in the surgery group (88.5%, p=0.042). The sample adequacy of EBUS-TBNA specimens was lower in the radiation group (80.3%) than in the surgery (95.4%, p<0.001) or palliation (97.8%, p<0.001) groups. EGFR mutation analysis was feasible in 94.6% of the 92 cases, in which mutation analysis was requested. There were no major complications. Minor complications were reported in 12 patients (3.3%).
EBUS-TBNA showed high diagnostic values and high suitability for EGFR mutation analysis with regard to re-biopsy in patients with previously treated lung cancer. The sensitivity was lower in the radiation group and NPV was lower in the palliation group. The complication rate was low.
Key words: Lung cancer, Endobronchial ultrasound, Biopsy
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