High SUVmax Is an Independent Predictor of Higher Diagnostic Accuracy of ROSE in EBUS-TBNA for Patients with NSCLC

Overview

Journal J Pers Med

Date 2022 Mar 25

PMID 35330451

Authors

Ying-Yi Chen

Hsin-Ya Huang

Chi-Yi Lin

Kuan-Liang Chen

Tsai-Wang Huang

Affiliations

Soon will be listed here.

Abstract

Introduction: This study aimed to verify the predictors of the diagnostic accuracy of rapid on-site evaluation (ROSE) in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) among patients with non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed consecutive patients with NSCLC who underwent EBUS-TBNA for staging or diagnosis at our hospital from June 2016 to June 2018. The patients were divided into two groups—those with a correct diagnosis and an incorrect diagnosis after ROSE. Kaplan−Meier plots and log-rank tests were used to estimate outcomes. Results: A total of 84 patients underwent EBUS-TBNA for staging and diagnosis. Sixty patients with demonstrated malignant mediastinal lymph nodes were enrolled. In the univariate analysis, lymph nodes < 1.5 cm (HR = 3.667, p = 0.031) and a SUVmax > 5 (HR = 41, p = 0.001) were statistically significant for diagnostic accuracy of ROSE. In the multivariate Cox regression analysis, only a SUVmax > 5 (HR = 20.258, p = 0.016) was statistically significant. Conclusions: A SUVmax > 5 is an independent predictor of higher diagnostic accuracy of ROSE in EBUS-TBNA in patients with NSCLC with malignant mediastinal lymph nodes. Therefore, ROSE in patients with a SUVmax < 5 might not be reliable and requires further prudent assessment (more shots or repeated biopsies at mediastinal LNs) in clinical practice.

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References

Guo H, Liu S, Guo J, Li B, Li W, Lu Z . Rapid on-site evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of hilar and mediastinal lymphadenopathy in patients with lung cancer. Cancer Lett. 2015; 371(2):182-6. DOI: 10.1016/j.canlet.2015.11.038. View

Jain D, Allen T, Aisner D, Beasley M, Cagle P, Capelozzi V . Rapid On-Site Evaluation of Endobronchial Ultrasound-Guided Transbronchial Needle Aspirations for the Diagnosis of Lung Cancer: A Perspective From Members of the Pulmonary Pathology Society. Arch Pathol Lab Med. 2017; 142(2):253-262. DOI: 10.5858/arpa.2017-0114-SA. View

Casal R, Staerkel G, Ost D, Almeida F, Uzbeck M, Eapen G . Randomized clinical trial of endobronchial ultrasound needle biopsy with and without aspiration. Chest. 2011; 142(3):568-573. PMC: 3610596. DOI: 10.1378/chest.11-0692. View

Nakajima T, Yasufuku K, Saegusa F, Fujiwara T, Sakairi Y, Hiroshima K . Rapid on-site cytologic evaluation during endobronchial ultrasound-guided transbronchial needle aspiration for nodal staging in patients with lung cancer. Ann Thorac Surg. 2012; 95(5):1695-9. DOI: 10.1016/j.athoracsur.2012.09.074. View

Zhang Y, Xie F, Mao X, Zheng X, Li Y, Zhu L . Determining factors of endobronchial ultrasound-guided transbronchial needle aspiration specimens for lung cancer subtyping and molecular testing. Endosc Ultrasound. 2019; 8(6):404-411. PMC: 6927142. DOI: 10.4103/eus.eus_8_19. View

Kandathil A, Kay F, Butt Y, Wachsmann J, Subramaniam R . Role of FDG PET/CT in the Eighth Edition of TNM Staging of Non-Small Cell Lung Cancer. Radiographics. 2018; 38(7):2134-2149. DOI: 10.1148/rg.2018180060. View

Louw M, Brundyn K, Schubert P, Wright C, Bolliger C, Diacon A . Comparison of the quality of smears in transbronchial fine-needle aspirates using two staining methods for rapid on-site evaluation. Diagn Cytopathol. 2011; 40(9):777-81. DOI: 10.1002/dc.21628. View

Kim Y, Lee K, Kim B, Choi J, Kim H, Kwon O . Mediastinal nodal staging of nonsmall cell lung cancer using integrated 18F-FDG PET/CT in a tuberculosis-endemic country: diagnostic efficacy in 674 patients. Cancer. 2007; 109(6):1068-77. DOI: 10.1002/cncr.22518. View

Layfield L, Bentz J, Gopez E . Immediate on-site interpretation of fine-needle aspiration smears: a cost and compensation analysis. Cancer. 2001; 93(5):319-22. DOI: 10.1002/cncr.9046. View

10.

Kim B, Lee K, Shim S, Choi J, Kwon O, Kim H . Stage T1 non-small cell lung cancer: preoperative mediastinal nodal staging with integrated FDG PET/CT--a prospective study. Radiology. 2006; 241(2):501-9. DOI: 10.1148/radiol.2412051173. View

11.

Yoon H, Ryu J, Sim Y, Kim D, Yong Lee S, Choi J . Clinical significance of EGFR mutation types in lung adenocarcinoma: A multi-centre Korean study. PLoS One. 2020; 15(2):e0228925. PMC: 7018076. DOI: 10.1371/journal.pone.0228925. View

12.

Han H, Eom D, Kim J, Kim K, Shin H, An J . EGFR mutation status in primary lung adenocarcinomas and corresponding metastatic lesions: discordance in pleural metastases. Clin Lung Cancer. 2011; 12(6):380-6. DOI: 10.1016/j.cllc.2011.02.006. View

13.

Bao F, Yuan P, Yuan X, Lv X, Wang Z, Hu J . Predictive risk factors for lymph node metastasis in patients with small size non-small cell lung cancer. J Thorac Dis. 2015; 6(12):1697-703. PMC: 4283338. DOI: 10.3978/j.issn.2072-1439.2014.11.05. View

14.

Wahidi M, Herth F, Yasufuku K, Shepherd R, Yarmus L, Chawla M . Technical Aspects of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: CHEST Guideline and Expert Panel Report. Chest. 2015; 149(3):816-35. DOI: 10.1378/chest.15-1216. View

15.

Lin M, Wu C, Shih J, Chang Y, Yang P . Clinicopathologic characteristics and prognostic significance of EGFR and p53 mutations in surgically resected lung adenocarcinomas ≤2 cm in maximal dimension. J Surg Oncol. 2014; 110(2):99-106. DOI: 10.1002/jso.23628. View

16.

van der Heijden E, Casal R, Trisolini R, Steinfort D, Hwangbo B, Nakajima T . Guideline for the acquisition and preparation of conventional and endobronchial ultrasound-guided transbronchial needle aspiration specimens for the diagnosis and molecular testing of patients with known or suspected lung cancer. Respiration. 2014; 88(6):500-17. DOI: 10.1159/000368857. View

17.

Kinsey C, Arenberg D . Endobronchial ultrasound-guided transbronchial needle aspiration for non-small cell lung cancer staging. Am J Respir Crit Care Med. 2014; 189(6):640-9. DOI: 10.1164/rccm.201311-2007CI. View

18.

Moulla Y, Gradistanac T, Wittekind C, Eichfeld U, Gockel I, Dietrich A . Predictive risk factors for lymph node metastasis in patients with resected non-small cell lung cancer: a case control study. J Cardiothorac Surg. 2019; 14(1):11. PMC: 6335711. DOI: 10.1186/s13019-019-0831-0. View

19.

Dyhdalo K, Booth C, Shorie J, Underwood D, Mazzone P, Brainard J . Rapid on-site evaluation of endobronchial ultrasound-guided fine-needle aspirates: correlation of adequacy assessment and final diagnosis in patients with bronchogenic carcinoma. J Am Soc Cytopathol. 2019; 3(4):199-205. DOI: 10.1016/j.jasc.2014.03.001. View

20.

Russell P, Wainer Z, Wright G, Daniels M, Conron M, Williams R . Does lung adenocarcinoma subtype predict patient survival?: A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung.... J Thorac Oncol. 2011; 6(9):1496-504. DOI: 10.1097/JTO.0b013e318221f701. View