Clinical validity of 25-gauge endobronchial ultrasound-guided transbronchial needle in lymph node staging of lung cancer

• 資料種別: 博士論文
• タイトル: Clinical validity of 25-gauge endobronchial ultrasound-guided transbronchial needle in lymph node staging of lung cancer
• 著者・編者: 大久保, 祐
• 著者標目: 大久保, 祐
• 出版事項: AME Publishing Company
• 出版年月日等: 2022-03-18
• 出版年（W3CDTF）: 2022-03-18
• 並列タイトル等: EBUS-TBNAによるリンパ節因子病期診断における25G針の有用性の検証
• タイトル（掲載誌）: Journal of Thoracic Disease
• 巻号年月日等（掲載誌）: 13 5
• 掲載巻: 13
• 掲載号: 5
• 掲載ページ: 3033-3041
• ISSN（掲載誌）: ISSN : 2072-1439; ISSN : 2077-6624
• 授与機関名: Nagasaki University (長崎大学)
• 授与年月日: 2022-03-18
• 報告番号: 甲医歯薬第1396号
• 学位: 博士(医学)
• 本文の言語コード: jpn
• 件名標目: Bronchoscopy; lung cancer; lymph nodes (LNs); staging; transbronchial needle aspiration
• 対象利用者: 一般
• 一般注記: Background: Endobronchial ultrasound-guided transbronchial needle aspiration is recommended for lymph node (LN) staging in lung cancer. Although 22-gauge needles are widely used, they may make some stations difficult to puncture owing to an acute angle. A thinner 25-gauge needle was introduced in Japan at the end of 2016 and offered structural advantages such as improved flexibility and penetrability. We aimed to validate the clinical utility of the 25-gauge needle in LN staging. Methods: Patients who underwent endobronchial ultrasound-guided transbronchial needle aspiration for LN staging of lung cancer using the 25-gauge needle at our institution between November 2016 and March 2019 were included. Patient characteristics, staging procedures, pathology findings, and genetic testing success rates were assessed. Results: Data of 130 patients were included in the analysis. The sampling rate was 87.6% (589/672 lesions). In addition to stations #4R, #7, and #11, which are generally easy to puncture, multiple stations (40.1%) were sampled. The diagnostic accuracy of combined computed tomography and fluorodeoxyglucose positron emission tomography was 82.3% and that of additional endobronchial ultrasound-guided transbronchial needle aspiration was 96.9%. The overall sensitivity, specificity, and positive and negative predictive values validated using resected specimens were 97.1% (34/35), 100% (41/41), 100% (34/34), and 97.6% (41/42), respectively. The success rate of genetic testing was 100% (34/34). Conclusions: The new 25-gauge needle enabled us to approach a wide range of LNs with a desirable sampling rate and diagnostic accuracy in LN staging using endobronchial ultrasound-guided transbronchial needle aspiration, while providing enough tissue for genetic testing.; 長崎大学学位論文 学位記番号:博(医歯薬)甲第1396号 学位授与年月日:令和4年3月18日; Author: Yu Okubo, Yuji Matsumoto, Midori Tanaka, Tatsuya Imabayashi, Yasuhito Uezono, Shun-ichi Watanabe, Takaaki Tsuchida; Citation: Journal of Thoracic Disease, 13(5), pp. 3033-3041; 2021; identifier:Nagasaki University (長崎大学), 博士(医学) (2022-03-18)
• 一次資料へのリンクURL: https://nagasaki-u.repo.nii.ac.jp/?action=repository_action_common_download&item_id=27360&item_no=1&attribute_id=70&file_no=1 （fulltext）; https://nagasaki-u.repo.nii.ac.jp/?action=repository_action_common_download&item_id=27360&item_no=1&attribute_id=70&file_no=1
• オンライン閲覧公開範囲: インターネット公開
• 著作権情報: © Journal of Thoracic Disease. This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
• 関連情報: http://hdl.handle.net/10069/00041157
• 関連情報（DOI）: 10.21037/jtd-20-3383
• 連携機関・データベース: 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• 提供元機関・データベース: 長崎大学 : 長崎大学学術研究成果リポジトリ