Desiree Steimer MD , Peter Tramontozzi BS , Patrick Gedeon MD, PhD , Matthew Pommerening MD, MS , Ariadne DeSimone MD, MPH , Raphael Bueno MD , Hisashi Tsukada MD, PhD
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引用次数: 0
摘要
背景：侵袭性纵隔分期是胸膜间皮瘤（PM）术前评估的重要组成部分。支气管超声（EBUS）在分期方面比纵隔镜检查侵入性小；然而，其在PM患者中的准确性仍不明确。我们介绍了我们在PM患者EBUS分期方面的机构经验。方法回顾性分析2017年1月至2021年2月期间（Brigham and Women Hospital, Boston， MA）因纵隔分期接受EBUS手术切除的PM患者。将EBUS细胞学与胸膜切除术时切除的相应淋巴结的最终病理报告进行比较，以评估EBUS的准确性。结果在研究期间，91例PM患者符合纳入标准。7号节点站EBUS诊断率最高（84%），4L节点站最低（40%）。74例患者行手术切除，41例患者有匹配淋巴结进行分析。在我们的研究中，EBUS的敏感性为81%，特异性为93%，阳性预测值为90%，阴性预测值为84%。结论sebus是间皮瘤患者纵膈腔分期的合理替代方法。
The Role of Endobronchial Ultrasound for Mediastinal Staging in Mesothelioma
Background
Invasive mediastinal staging is a crucial component of the preoperative evaluation for potential surgical candidates with pleural mesothelioma (PM). Endobronchial ultrasound (EBUS) is less invasive than mediastinoscopy for staging; however, its accuracy in patients with PM remains undefined. We present our institutional experience with EBUS staging in patients with PM.
Methods
Patients with PM who underwent EBUS for mediastinal staging between January 2017 and February 2021 (Brigham and Women's Hospital, Boston, MA) followed by surgical resection were retrospectively reviewed. EBUS cytology was compared with final pathology reports for the corresponding lymph node removed at the time of pleurectomy to assess EBUS accuracy.
Results
During the study period, 91 patients with PM met inclusion criteria. EBUS diagnostic yield was highest at nodal station 7 (84%) and lowest at station 4L (40%). There were 74 patients taken for surgical resection, and 41 patients had matching lymph nodes for analysis. In our series, EBUS had a sensitivity of 81%, a specificity of 93%, a positive predictive value of 90%, and a negative predictive value of 84%.
Conclusions
EBUS is a reasonable alternative to mediastinoscopy for mediastinal staging in patients with mesothelioma.
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