Diagnostic yield of combined ultrasound-guided fine needle aspiration and core needle biopsy versus either technique alone in peripheral lung and pleural lesions

IF 1 Q4 RESPIRATORY SYSTEM
Rania Ahmed Sweed, Yehia Mohamed Khalil, Hany Amin Sharawy, Eman Sheta Ali Gawdat Alsawy, Mina Botros
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Abstract

Abstract Introduction Ultrasound (US) has become an integral tool for chest assessment as it provides crucial information on pleural pathologies and peripherally located lung lesions. Aim To assess the diagnostic yield of combined fine needle aspiration (FNAB) and core needle biopsy (CNB) versus each technique ultrasound-guided in peripheral lung and pleural lesions. Methodology The present study enrolled 30 patients presenting to Alexandria Main University Hospital, with CT scans showing undiagnosed peripheral lung or parietal pleural lesions with or without effusion. A full ultrasound chest assessment was done covering 12 regions. Assessment of the lesion of interest, vascularity was assessed via color Doppler, locating the safest entry site. Real-time US-guided FNAB was done using a spinal needle 22 gauge. Then real-time US-guided CNB using 18 gauge Trucut needle in the same setting. Duration and complications of each procedure were reported. In FNAB, three smears were prepared, fixed in alcohol, and stained with hematoxylin and eosin stain. The remaining sample was fixed in formalin and centrifuged to prepare cell blocks. On the other hand, Trucut needle biopsy specimens were fixed in formalin and processed as paraffin-embedded blocks. Immunohistochemical staining was done. The results were classified into four categories (inadequate, negative, suspicious, and positive for malignancy. Results The diagnostic yield of combined techniques was 96.7% versus 63.3% using FNAB and 96.7% using CNB. The sensitivity of FNAB was 86% while CNB was 95%. The specificity and positive predictive value of both methods were 100%. The negative predictive value of FNAB was 57% versus 80% for CNB in peripheral lung lesions. Duration of US-guided CNB was statistically significantly longer than that of FNAB in both peripheral lung and pleural lesions. No major complications were reported using either technique. Conclusion Combined FNAB and CNB were not superior to CNB alone regarding diagnostic yield but were superior to FNAB. Ultrasound-guided CNB has a superior diagnostic yield over FNAB, with no statistically significant difference regarding associated complications, both techniques are safe. FNAB provided sufficient material for ancillary molecular testing.
超声引导下细针穿刺联合核心针活检对周围性肺和胸膜病变的诊断效果
超声(US)已成为胸部评估不可或缺的工具,因为它提供了胸膜病理和周围肺病变的重要信息。目的比较超声引导下细针穿刺(FNAB)和核心针活检(CNB)联合应用对周围性肺和胸膜病变的诊断效果。本研究纳入了30例在亚历山大大学医院就诊的患者,CT扫描显示未确诊的肺周围或胸膜壁病变伴或不伴积液。对12个区域进行了全面的超声胸部评估。对感兴趣的病变进行评估,通过彩色多普勒评估血管活通性,确定最安全的进入部位。实时导引FNAB采用脊髓针22规。然后在相同的位置使用18号truut针进行实时美导CNB。报告了每次手术的持续时间和并发症。在FNAB中制备三张涂片,用酒精固定,并用苏木精和伊红染色。剩余样品用福尔马林固定,离心制备细胞块。另一方面,将Trucut针活检标本用福尔马林固定,制成石蜡包埋块。免疫组织化学染色。结果分为四类(不充分、阴性、可疑和恶性肿瘤阳性)。结果两种方法的诊断率分别为96.7%、63.3%和96.7%。FNAB的敏感性为86%,CNB的敏感性为95%。两种方法的特异性和阳性预测值均为100%。FNAB对周围性肺病变CNB的阴性预测值为57%,而阴性预测值为80%。在肺周围和胸膜病变中,us引导下CNB的持续时间均明显长于FNAB。两种方法均无重大并发症报道。结论FNAB联合CNB的诊断率不优于单用CNB,但优于FNAB。超声引导下CNB的诊断率优于FNAB,在相关并发症方面无统计学差异,两种技术都是安全的。FNAB为辅助分子检测提供了充足的材料。
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来源期刊
Egyptian Journal of Bronchology
Egyptian Journal of Bronchology RESPIRATORY SYSTEM-
自引率
7.70%
发文量
56
审稿时长
9 weeks
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