Open AccessThe reasons of false negative results of endobronchial ultrasound‐guided transbronchial needle aspiration in the diagnosis of intrapulmonary and mediastinal malignancy
Author(s) -
Tian Qing,
Chen LiangAn,
Wang RenTao,
Yang Zhen,
An Yang
Publication year - 2013
Publication title -
thoracic cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 28
eISSN - 1759-7714
pISSN - 1759-7706
DOI - 10.1111/1759-7714.12010
Subject(s) - medicine , malignancy , radiology , endobronchial ultrasound , lung cancer , pathological , predictive value of tests , predictive value , bronchoscopy , retrospective cohort study , positive predicative value , pathology
Although the sensitivity can reach 99%, endobronchial ultrasound‐guided transbronchial needle aspiration ( EBUS‐TBNA ) has a significantly high false negative rate for diagnosis and staging of thoracic malignancy. We performed this retrospective study to investigate the causes of false negative results and to improve the efficacy and accuracy of EBUS‐TBNA . We reviewed all patients suspected of intrapulmonary or mediastinal malignancy who undertook EBUS‐TBNA between J uly 2009 and A ugust 2012 in C hinese PLA general hospital. We retrieved the pathological results of EBUS‐TBNA and video‐assisted thoracic surgery ( VATS ) and follow‐up data. The sensitivity, specificity, positive predictive value and negative predictive value were calculated. 185 patients were included in this study. Diagnosis of malignancy was established on 172 patients by EBUS‐TBNA , and 8 patients with negative EBUS‐TBNA result gained their final diagnosis of malignancy via VATS . The sensitivity, specificity, negative predictive value and accuracy for diagnosis of malignancy for EBUS‐TBNA were 96%, 100%, 33% and 96% respectively. Inadequacy of the EBUS‐TBNA specimens, internal necrosis in the lymph nodes and rare cancer types contributed to the false negative EBUS‐TBNA results. VATS is obligatory to explain the negative results of EBUS‐TBNA in patients suspected of malignancy.