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

• Material Type: 博士論文
• Title: Clinical validity of 25-gauge endobronchial ultrasound-guided transbronchial needle in lymph node staging of lung cancer
• Author/Editor: 大久保, 祐
• Author Heading: 大久保, 祐
• Publication, Distribution, etc.: AME Publishing Company
• Publication Date: 2022-03-18
• Publication Date (W3CDTF): 2022-03-18
• Alternative Title: 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
• Periodical title: Journal of Thoracic Disease
• No. or year of volume/issue: 13 5
• Volume: 13
• Issue: 5
• Pages: 3033-3041
• ISSN (Periodical Title): ISSN : 2072-1439; ISSN : 2077-6624
• Degree grantor/type: Nagasaki University (長崎大学)
• Date Granted: 2022-03-18
• Dissertation Number: 甲医歯薬第1396号
• Degree Type: 博士(医学)
• Text Language Code: jpn
• Subject Heading: Bronchoscopy; lung cancer; lymph nodes (LNs); staging; transbronchial needle aspiration
• Target Audience: 一般
• Note (General): 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)
• Source: 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
• Access Restrictions: インターネット公開
• Rights (production): © 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).
• Related Material: http://hdl.handle.net/10069/00041157
• Related Material (DOI): 10.21037/jtd-20-3383
• Data Provider (Database): 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
• Original Data Provider (Database): 長崎大学 : 長崎大学学術研究成果リポジトリ