Introduction
Materials and methods
Study population and EBUS-TBNA procedure
Specimens’ management
Traditional direct smear method production cytology
Liquid thin-layer cytology technology production
Histopathological examination
Diagnostic criteria
Statistical analysis
Results
Parameters of patients and lesions
Baseline characteristics | |||
---|---|---|---|
Patients (male/female) | 181 (129/52) | ||
Mean age (range), years | 61.5 ± 9.9 (26–79) | ||
Smoking history | |||
Never smoker | 65(35.9%) | ||
Ex-smoker | 85(47.0%) | ||
Current smoker | 31(17.1%) | ||
Known/suspected lung cancer | 59/122 | ||
Station of LNs | |||
2 L | 1(0.45%) | ||
2R | 5(2.3%) | ||
4 L | 13(6.1%) | ||
4R | 65(30.5%) | ||
7 | 51(23.9%) | ||
10 L | 2(0.9%) | ||
10R | 13(6.1%) | ||
11 L | 8 (3.8%) | ||
11R | 10(4.7%) | ||
12 L | 6(2.8%) | ||
12R | 13(6.1%) | ||
Mass | 26(12.2%) | ||
Number of LNs station per patient | |||
1 station | 151(93.1%) | ||
2 stations | 28(6.3%) | ||
3 stations | 2(0.6%) | ||
Final diagnosis for LNs, n (%) | Metastatic lung cancer 155 (72.8)§ | ||
Metastatic extrathoracic cancer 5 (2.3)† | |||
Cancer type unknown 7 (3.3) | |||
Lymphoma 6 (2.8)❈ | |||
Non-malignancy 40 (18.8)‡ |
Diagnostic efficiency of different specimen preparation methods
Positive, n (%) | Negative, n (%) | Diagnostic positive rate, n (%) | χ2 | p value | |
---|---|---|---|---|---|
HP | 72.3(154) | 27.7(59) a | 72.3 (154) | ||
TSC | 69.0(147) b | 31.0(66) c | 69.0 (147) | ||
LBC | 65.7(140) d | 34.3(73) e | 65.7 (140) | 2.152# | 0.341# |
HP + TSC | 78.9(168) b | 21.1(45) f | 78.9 (168) | 9.874## | 0.020## |
HP + LBC | 77.0(164) d | 23.0(49) g | 77.0 (164) | 7.178### | 0.066### |
HP + TSC + LBC | 81.2(173) h | 18.8(40) k | 81.2 (173) | 1.152*, 14.11& | 0.562*,0.003& |
Final diagnosis | 81.2(173) | 18.8(40) | 81.2 (173) |
Sensitivity, % (95% CI) | Specificity, % (95% CI) | PPV, % (95% CI) | NPV, % (95% CI) | Diagnostic accuracy, % (95% CI) | χ2 | p value | |
---|---|---|---|---|---|---|---|
HP | 89.0(83.4–93.3) | 100(91.2–100) | 100 | 67.8(57.9–76.3) | 91.1(86.4–94.5) | ||
TSC | 83.8(77.5–88.9) | 95.0(83.1–99.4) | 98.6(94.9–99.6) | 57.6(49.0-65.7) | 85.9(80.5–90.3) | ||
LBC | 80.3(73.6–86.0) | 97.5(86.8–99.9) | 99.3(95.2–99.9) | 53.3(45.8–60.9) | 83.6(77.9–88.3) | 5.51▼ | 0.064▼ |
HP + TSC | 97.1(93.3–99.1) | 95.0(83.1–99.4) | 98.8(95.6–99.7) | 86.4(76.2–94.8) | 96.2(93.3–98.7) | 21.15★ | 0.000★ |
HP + LBC | 94.8(90.4–97.6) | 97.5(86.8–99.9) | 99.4(95.9–99.9) | 81.2(69.6–89.1) | 95.3(91.5–97.7) | 18.03■ | 0.000■ |
HP + TSC + LBC | 98.3(95.0-99.6) | 92.5(79.6–98.4) | 98.3(95.0-99.4) | 92.5(80.0-97.4) | 97.2(94.0–99.0) | 1.04△, 24.69▽ | 0.595△, 0.000▽ |
Diagnostic consistency of different specimen preparation methods
HP | Final diagnosis | TSC | Final diagnosis | LBC | Final diagnosis | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Positive | Negative | Total | Positive | Negative | Total | Positive | Negative | Total | |||
Positive | 154 | 0 | 154 | Positive | 145 | 2 | 147 | Positive | 139 | 1 | 140 |
Negative | 19 | 40 | 59 | Negative | 28 | 38 | 66 | Negative | 34 | 39 | 73 |
Total | 173 | 40 | 213 | Total | 173 | 40 | 213 | Total | 173 | 40 | 213 |
HP + TSC | Final diagnosis | HP + LBC | Final diagnosis | HP + TSC + LBC | Final diagnosis | ||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Positive | Negative | Total | Positive | Negative | Total | Positive | Negative | Total | |||
Positive | 168 | 2 | 170 | Positive | 164 | 1 | 165 | Positive | 170 | 3 | 173 |
Negative | 5 | 38 | 43 | Negative | 9 | 39 | 48 | Negative | 3 | 37 | 40 |
Total | 173 | 40 | 213 | Total | 173 | 40 | 213 | Total | 173 | 40 | 213 |